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Huyett P, Monaco SE, Choi SS, Simons JP. Utility of fine-needle aspiration biopsy in the
evaluation of pediatric head and neck masses.
Otolaryngol Head Neck Surg
. 2016;
154(5):928-935. EBM level 4........................................................................................190-197
Summary
: This article evaluates the use of fine-needle aspiration biopsy (FNAB) to assess
head and neck masses in the pediatric population. A total of 257 consecutive patients
underwent FNAB in the interventional radiology suite, operating room, clinic, or ward from
2007-2014. Most common diagnoses were reactive lymphadenopathy (38.5%), benign
thyroid colloid nodule (12.1%), malignancy (8.2%), and atypical mycobacterial infection
(5.8%). FNAB yielded an overall sensitivity of 94.6% and specificity of 97.7%.
Complication rate was 2.1%. Most patients required sedation or anesthesia for the FNAB
procedure. Negative FNAB can be utilized to provide reassurance to avoid unnecessary
surgery with its associated morbidity and cost.
Léauté-Labrèze C, Hoeger P, Mazereeuw-Hautier J, et al. A randomized, controlled trial of
oral propranolol in infantile hemangioma.
N Engl J Med
. 2015; 372(8):735-746. EBM
level 1..............................................................................................................................198-209
Summary
: This article summarizes the results of a randomized controlled trial on the use of
propranolol to treat complicated infantile hemangioma. A total of 460 patients were
randomized to receive placebo or one of four propranolol dosing regimens (1 or 3 mg/kg/day
for 3 or 6 months). The regimen of 3 mg/kg/day for 6 months was found to be the most
effective dosing regimen, with 60% of patients having complete or near-complete resolution
of hemangioma vs. 4% in the placebo group. Adverse events were more common in the
propranolol-treated groups (90%) compared to the placebo group (76%).