Oral Propranolol Therapy for Parotid Infantile Hemangiomas: Lesion Characteristics Affecting Outcome

Abstract Parotid hemangioma is a common type of infantile hemangioma (IH) in the head and neck region. Oral propranolol therapy has been therapeutic for head and neck IH. The objective was to investigate the varied characteristics of lesions and the types of response to propranolol therapy in the treatment of parotid IHs from July 2013 to November 2024. After an initial screening and investigations (random blood sugar, renal and liver function tests), counselling, and consent, 3 mg/kg/d of propranolol was started. Children were evaluated after 2 weeks, 1 month, 2 months, and at 3 months after the start of treatment by photographic assessment. Response was noted in terms of percentage reduction and charted against various lesion characteristics. Statistical analysis was conducted to determine the effectiveness of propranolol with regard to different lesion characteristics, namely site, size, associated skin discoloration, extension, and consistency. Out of total 12 patients, nine were males. Nine had right-sided lesions. One had an ulcerated lesion, two were deep, rest superficial as well as deep. Six patients showed more than 50% reduction of lesion, four showed >90% reduction to complete disappearance, one patient had <50% reduction and one had no response at all. Only one patient had re-growth after 4 months of discontinuation of treatment and was restarted on propranolol. Propranolol pharmacotherapy alone was more effective in reducing the size of infantile parotid IH that were superficial, firm, and smaller in size, as compared to those that were deep lesions and flabby to feel.