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Evaluation of the efficacy and safety of topical timolol maleate combined with oral propranolol treatment for parotid mixed infantile hemangiomas

View Article: PubMed Central - PubMed

ABSTRACT

The aim of the present study was to assess the efficacy and safety of topical timolol maleate combined with oral propranolol for parotid infantile hemangiomas. Between October 2012 and April 2014, propranolol was administered orally at a dose of 1.0–1.5 mg/kg/day to 22 infants with proliferating hemangiomas in the Department of Oral and Maxillofacial Surgery (Hospital of Stomatology, China Medical University, Shenyang, Liaoning, China). A small amount of 0.5% timolol maleate eye drop solution was topically applied with medical cotton swabs to the area of the lesion twice a day, every 12 h. The study group consisted of 9 males and 13 females, aged 2–9 months, with a median age of 4.7 months. The lesions were all located in the parotid region, and measured between 3.5×4×0.5 and 7×8×3 cm in volume. The planned duration of therapy was 6–8 months, or the two drugs were stopped when complete regression of the lesions was obtained. The therapeutic outcomes and safety were assessed by the change in the size and color of the tumor, and the presence of adverse effects throughout the course of treatment. The mean duration of therapy was 21.1 weeks and ranged from 3 to 8 months. Of the 22 patients, 16 demonstrated an excellent response, 6 showed a good response and 2 displayed a moderate response. No major collateral effects were observed. Overall, oral propranolol combined with topical timolol maleate may be used as the first-line therapeutic choice in the treatment of infantile parotid mixed hemangioma.

No MeSH data available.


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A pediatric patient (patient no. 6) with an infantile hemangioma in the left parotid area at (A) 6 months of age, prior to treatment, and (B) at 4 years of age, 28 weeks after topical timolol maleate combined with oral propranolol treatment. The coloration of the tumor was markedly decreased.
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f1-ol-0-0-4818: A pediatric patient (patient no. 6) with an infantile hemangioma in the left parotid area at (A) 6 months of age, prior to treatment, and (B) at 4 years of age, 28 weeks after topical timolol maleate combined with oral propranolol treatment. The coloration of the tumor was markedly decreased.

Mentions: All the hemangiomas decreased in size following treatment and in the majority of cases, the tumor color changed from bright red to dull red. Efficacy scores was evaluated as follows: IV (excellent), 14 cases (64%); III (good), 6 cases (27%); II (moderate), 2 cases (9%); and I (poor), 0 cases (0%). The parents were quite satisfied with the results. At 24 h post-medication, the tension of the tumor surface of the majority of children decreased and the texture became softer. In total, the drug was administered for 12 weeks in 3 patients, for 16 weeks in 5 patients, for 20 weeks in 4 patients, for 24 weeks in 5 patients, for 28 weeks in 3 patients and for 32 weeks in 2 patients, with a mean time of 21.1 weeks. The tumor of 1 patient regressed completely following 16 weeks of treatment. However, the tumor had relapsed when the infant was followed up 6 weeks later and the proliferation was subsequently effectively controlled by the continuation of medication for ~10 weeks after treatment, until it decreased in size. Typical cases are shown in Figs. 1 and 2.


Evaluation of the efficacy and safety of topical timolol maleate combined with oral propranolol treatment for parotid mixed infantile hemangiomas
A pediatric patient (patient no. 6) with an infantile hemangioma in the left parotid area at (A) 6 months of age, prior to treatment, and (B) at 4 years of age, 28 weeks after topical timolol maleate combined with oral propranolol treatment. The coloration of the tumor was markedly decreased.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998099&req=5

f1-ol-0-0-4818: A pediatric patient (patient no. 6) with an infantile hemangioma in the left parotid area at (A) 6 months of age, prior to treatment, and (B) at 4 years of age, 28 weeks after topical timolol maleate combined with oral propranolol treatment. The coloration of the tumor was markedly decreased.
Mentions: All the hemangiomas decreased in size following treatment and in the majority of cases, the tumor color changed from bright red to dull red. Efficacy scores was evaluated as follows: IV (excellent), 14 cases (64%); III (good), 6 cases (27%); II (moderate), 2 cases (9%); and I (poor), 0 cases (0%). The parents were quite satisfied with the results. At 24 h post-medication, the tension of the tumor surface of the majority of children decreased and the texture became softer. In total, the drug was administered for 12 weeks in 3 patients, for 16 weeks in 5 patients, for 20 weeks in 4 patients, for 24 weeks in 5 patients, for 28 weeks in 3 patients and for 32 weeks in 2 patients, with a mean time of 21.1 weeks. The tumor of 1 patient regressed completely following 16 weeks of treatment. However, the tumor had relapsed when the infant was followed up 6 weeks later and the proliferation was subsequently effectively controlled by the continuation of medication for ~10 weeks after treatment, until it decreased in size. Typical cases are shown in Figs. 1 and 2.

View Article: PubMed Central - PubMed

ABSTRACT

The aim of the present study was to assess the efficacy and safety of topical timolol maleate combined with oral propranolol for parotid infantile hemangiomas. Between October 2012 and April 2014, propranolol was administered orally at a dose of 1.0–1.5 mg/kg/day to 22 infants with proliferating hemangiomas in the Department of Oral and Maxillofacial Surgery (Hospital of Stomatology, China Medical University, Shenyang, Liaoning, China). A small amount of 0.5% timolol maleate eye drop solution was topically applied with medical cotton swabs to the area of the lesion twice a day, every 12 h. The study group consisted of 9 males and 13 females, aged 2–9 months, with a median age of 4.7 months. The lesions were all located in the parotid region, and measured between 3.5×4×0.5 and 7×8×3 cm in volume. The planned duration of therapy was 6–8 months, or the two drugs were stopped when complete regression of the lesions was obtained. The therapeutic outcomes and safety were assessed by the change in the size and color of the tumor, and the presence of adverse effects throughout the course of treatment. The mean duration of therapy was 21.1 weeks and ranged from 3 to 8 months. Of the 22 patients, 16 demonstrated an excellent response, 6 showed a good response and 2 displayed a moderate response. No major collateral effects were observed. Overall, oral propranolol combined with topical timolol maleate may be used as the first-line therapeutic choice in the treatment of infantile parotid mixed hemangioma.

No MeSH data available.


Related in: MedlinePlus