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DOI: 10.1055/s-0038-1660969
Infantile Hämangiome im Lid- und Orbitabereich
Infantile hemangiomas of the eyelids and the orbitPublication History
Eingereicht am:
28 December 2017
angenommen am:
22 February 2018
Publication Date:
05 June 2018 (online)
Zusammenfassung
Infantile Hämangiome im Lid- und Orbitabereich können trotz ihres selbstlimitierenden natürlichen Verlaufs zu funktionellen Defiziten infolge einer Amblyopie oder Optikuskompression führen oder ein ästhetisch störendes Erscheinungsbild entwickeln und bedürfen dann einer Therapie.
Seit der „zufälligen” Entdeckung des Effektes von Propranolol auf infantile Hämangiome im Jahr 2008 wird diese Substanz zur Behandlung komplizierter Hämangiome eingesetzt, die ansonsten den Einsatz von Kortikosteroiden, Laser oder operativen Verfahren erfordert hätten. Propranolol systemisch ist derzeit bei komplizierten Hämangiomen der Lider und Orbita aufgrund des raschen und komplikationsarmen Therapieeffektes Therapie der ersten Wahl.
Dargestellt werden Pathogenese, Klassifikation, Indikation zur Therapie, Therapieoptionen sowie deren Effektivität für infantile Hämangiome im Lid- und Orbitabereich.
Weitere klinische Studien zur Optimierung von Dosierung, Behandlungsdauer und Art der Anwendung von Propranolol (lokal oder systemisch) sind jedoch weiterhin erforderlich, um den Regressionseffekt und die Regressionsrate weiter zu verbessern.
Summary
Despite the self-limiting natural course of infantile hemangiomas of the eyelids and orbit, effects of amblyopia, compression of the optic nerve, and impairment of the esthetic appearance may develop and in these cases therapy is necessary.
Since the serendipitous discovery of the effects of propranolol on infantile haemangioma in 2008, it has largely replaced the former standard treatments with corticosteroids, laser or surgical procedures. Propranolol is now the gold standard of therapy for complicated hemangiomas of the eyelids, and the orbit because of the prompt therapeutic effect and the less rate of complications.
This review discusses the pathogenesis, classification, indication of treatment, and treatment options and the treatment efficacy of propranolol for infantile hemangiomas of the eyelids and orbit.
Further clinical studies are necessary to optimize the dosage of propranolol, treatment period, and application modalities (oral or topical) and to improve the efficacy and rate of regression of hemangiomas.
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