A 4-month-old infant has biphasic stridor since 6 weeks of age, worsening with respiratory infections. Examination shows a segmental haemangioma over the beard area of the face. Endoscopy confirms a compressive subglottic lesion. First-line systemic therapy is:

• A Oral prednisolone long term
• B Intralesional bleomycin
• C Oral propranolol ✓
• D Anterior cricoid split

Explanation

Subglottic haemangioma classically presents with biphasic stridor in infancy and may be associated with cutaneous haemangiomas, especially in the beard distribution, which predicts airway involvement. Propranolol is now first-line systemic therapy and has largely replaced corticosteroids, producing regression of the lesion. Surgery is reserved for lesions failing medical therapy or causing critical obstruction, and intralesional bleomycin is not standard care.

Reference: Scott-Brown's Essential Otorhinolaryngology, 2nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.