Diagnosis and Management of Infantile Hemangioma

Table D. Summary of evidence in studies addressing effectiveness of surgical interventions
Intervention
Type/Number of
Studies (Total N
Participants)
Key Outcome(s)
Strength of
Evidence
(SOE) Grade
Lasers
Longer pulse PDL vs
other laser types and
protocols
RCT: 1 (52)
Findings
Improvement in IH Low Resolution outcomes similar between laser types.
Low SOE for no difference in effects on size reduction between longer
pulse PDL and various other lasers given few studies, medium
limitations, and inconsistent and imprecise findings.
Cohort studies: 2
(212)
PDL vs. Observation
RCT: 2 (143)
PDL vs. Observation
RCT: 2 (143)
Nd:YAG with
extended cooling vs.
Nd:YAG with
standard cooling
Cohort studies:1
(290)
Nd:YAG vs. CO2
laser vs.
Tracheostomy
Cohort studies: 1 (46)
Improvement in IH Low No significant difference in measured volume or proportion of clearance
between groups; greater observer-ratings of improvement for PDL arm
in one study.
Low SOE for effectiveness of PDL vs. observation in reducing lesion
size.
Quality of life Low No significant differences in parent ratings of QoL in one study; more
parents of children in PDL arm in another considered appearance
improved than in observation arm.
Low SOE for no difference between PDL treatment and observation in
reducing lesion size due to lack of precision, few studies..
Improvement in IH Insufficient Improved resolution with extended cooling protocol vs. traditional in
single study with medium limitations.
Insufficient SOE given single study with medium limitations.
Speech Insufficient 75% of children with tracheostomy had delayed speech vs. 0 with no
tracheostomy in the laser treatment era.
Insufficient SOE given small, single study with high limitations.
ES-24