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[Diode laser application for the treatment of pediatric airway pathologies].
Cir Pediatr. 2008 Apr; 21(2):79-83.CP

Abstract

Laser application for the treatment of pediatric airway pathologies represents a very attractive option because of the limited inflammatory reaction after photocoagulation. One novel laser used for such pathologies is the diode laser.

AIM

The purpose of this report is to present our preliminary experience in the use of diode laser in the treatment of pediatric airway lesions.

METHODS

A retrospective review of 22 patients (11 males and 11 females) who underwent laser procedures from 1999 to 2006 was performed. Nineteen patients were treated at our center while 3 were referred after a laser application from other institution. In all procedures flexible bronchoscopy was used. The mean age was 1.25 years (range 1 month-4.8 years). Lasers were applied for various lesions: laryngomalacia and arytenoid lesions (n = 5), angiomas (n = 3), lymphangiomas (n = 3), sacular cyst and other mucous lesions (n = 3), granulomas, scarring lesions (n = 4) and paralysis of vocal cord in adduction (n = 1).

RESULTS

None of the patient developed complications related to the endoscopic laser application. The mean number of laser therapy attempts were 1.4 per patient (range 1-3). The patients remained intubated for a mean of 2.8 days (range 4 hours-13 days) after the procedure. The duration of PICU stay after laser therapy was a mean of 4.6 days (range 1-8 days). The best outcomes were seen in sacular cysts (excelent in 3 patients). Also, all 3 patients with granulomas showed a good response to treatment. Multiple laser sessions (1-3; mean 1.4) were required to sucessfully manage the artynenoid lesions. However, the children with vascular lesions demonstrated differents outcomes. Of the 3 patients with subglottic angioma, 2 underwent a subsequent surgical procedure due to the development of subglottic stenosis; and one requiered further systemic steroid therapy. Of the children with lymphangioma, one needed 3 laser sessions and two required surgi- cal resections. Despite laser treatment, 3 of the 4 patients with scarring lesions required surgery.

CONCLUSIONS

The endoscopic application of diode laser for the management of pediatric airways lesions provides good outcomes in selected patients. Sacular lesions, granulomas and arytenoid lesions are, in our experience, excellents indications. In other anomalies laser is a good adjuvant. The application of laser should be tailored according to the pathology.

Authors+Show Affiliations

Servicio de Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid. mariafanjul@yahoo.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

spa

PubMed ID

18624274

Citation

Fanjul, M, et al. "[Diode Laser Application for the Treatment of Pediatric Airway Pathologies]." Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica, vol. 21, no. 2, 2008, pp. 79-83.
Fanjul M, García-Casillas MA, Parente A, et al. [Diode laser application for the treatment of pediatric airway pathologies]. Cir Pediatr. 2008;21(2):79-83.
Fanjul, M., García-Casillas, M. A., Parente, A., Cañizo, A., Laín, A., Matute, J. A., & Vázquez, J. (2008). [Diode laser application for the treatment of pediatric airway pathologies]. Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica, 21(2), 79-83.
Fanjul M, et al. [Diode Laser Application for the Treatment of Pediatric Airway Pathologies]. Cir Pediatr. 2008;21(2):79-83. PubMed PMID: 18624274.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Diode laser application for the treatment of pediatric airway pathologies]. AU - Fanjul,M, AU - García-Casillas,M A, AU - Parente,A, AU - Cañizo,A, AU - Laín,A, AU - Matute,J A, AU - Vázquez,J, PY - 2008/7/16/pubmed PY - 2008/10/4/medline PY - 2008/7/16/entrez SP - 79 EP - 83 JF - Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica JO - Cir Pediatr VL - 21 IS - 2 N2 - UNLABELLED: Laser application for the treatment of pediatric airway pathologies represents a very attractive option because of the limited inflammatory reaction after photocoagulation. One novel laser used for such pathologies is the diode laser. AIM: The purpose of this report is to present our preliminary experience in the use of diode laser in the treatment of pediatric airway lesions. METHODS: A retrospective review of 22 patients (11 males and 11 females) who underwent laser procedures from 1999 to 2006 was performed. Nineteen patients were treated at our center while 3 were referred after a laser application from other institution. In all procedures flexible bronchoscopy was used. The mean age was 1.25 years (range 1 month-4.8 years). Lasers were applied for various lesions: laryngomalacia and arytenoid lesions (n = 5), angiomas (n = 3), lymphangiomas (n = 3), sacular cyst and other mucous lesions (n = 3), granulomas, scarring lesions (n = 4) and paralysis of vocal cord in adduction (n = 1). RESULTS: None of the patient developed complications related to the endoscopic laser application. The mean number of laser therapy attempts were 1.4 per patient (range 1-3). The patients remained intubated for a mean of 2.8 days (range 4 hours-13 days) after the procedure. The duration of PICU stay after laser therapy was a mean of 4.6 days (range 1-8 days). The best outcomes were seen in sacular cysts (excelent in 3 patients). Also, all 3 patients with granulomas showed a good response to treatment. Multiple laser sessions (1-3; mean 1.4) were required to sucessfully manage the artynenoid lesions. However, the children with vascular lesions demonstrated differents outcomes. Of the 3 patients with subglottic angioma, 2 underwent a subsequent surgical procedure due to the development of subglottic stenosis; and one requiered further systemic steroid therapy. Of the children with lymphangioma, one needed 3 laser sessions and two required surgi- cal resections. Despite laser treatment, 3 of the 4 patients with scarring lesions required surgery. CONCLUSIONS: The endoscopic application of diode laser for the management of pediatric airways lesions provides good outcomes in selected patients. Sacular lesions, granulomas and arytenoid lesions are, in our experience, excellents indications. In other anomalies laser is a good adjuvant. The application of laser should be tailored according to the pathology. SN - 0214-1221 UR - https://www.unboundmedicine.com/medline/citation/18624274/[Diode_laser_application_for_the_treatment_of_pediatric_airway_pathologies]_ DB - PRIME DP - Unbound Medicine ER -