Intralesional steroid injection for proliferative parotid hemangiomas

SummaryObjectiveTo evaluate the efficacy of proliferative phase intralesional steroid injections in the treatment of parotid hemangiomas.DesignRetrospective analysis of pediatric patients with parotid hemangiomas treated with intralesional steroid injections during the proliferative phase.SettingVascular Anomalies Center, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas, USA.PatientsTwenty-one pediatric patients, ages 4–39 months.MethodsBetween 2001 and 2006, 21 patients received steroid injections for 23 parotid hemangiomas (bilateral in 2 patients). A total of 1–3 injections over the first year of life were given at 6–25 week intervals.ResultsMain outcome measures included softening, decreased growth rate, and/or decrease in size. After injection, achievement of outcome measures occurred with all lesions. No incidence of tissue atrophy or facial nerve injury was seen. Four of 21 (19%) patients developed failure to thrive (FTT).ConclusionParotid hemangiomas can be effectively controlled with proliferative phase intralesional steroid injections. Injections may limit the need for future extensive surgery. Further prospective randomized trials are needed to support these claims. Failure to thrive may be a potential complication of intralesional steroid injection. Endocrine/growth monitoring should be considered when treating with intralesional steroids.