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Rare Subglottic Hemangioma Causing 50% Obstruction of the Subglottic Space
Case description
A 9-month-old infant was referred to our ENT department for evaluation of persistent moderate inspiratory stridor, present since early infancy and clearly exacerbated during upper respiratory tract infections. The clinical history was also notable for recurrent episodes of cough and symptoms suggestive of extra-esophageal reflux. Despite conservative management, respiratory symptoms persisted.
An awake flexible nasopharyngolaryngoscopy was initially performed and showed no anatomical abnormalities of the nasal cavities, pharynx, or supraglottic and glottic structures. Given the persistence of symptoms and the absence of findings on flexible endoscopy, further airway evaluation under general anesthesia was indicated.
A rigid laryngotracheal endoscopy was subsequently performed, revealing a subglottic hemangioma causing approximately 50% obstruction of the subglottic airway. The lesion was consistent with a vascular mass arising from the subglottic region, explaining the progressive stridor and respiratory symptoms.
Following the diagnosis, the patient was referred to the pediatrics department for initiation of systemic propranolol therapy. Close multidisciplinary follow-up was planned to monitor airway patency, treatment response, and overall clinical evolution.
