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CO2 laser excision of pediatric airway lesions.
J Pediatr Surg. 1990 Nov; 25(11):1152-6.JP

Abstract

Treatment of life-threatening pediatric airway lesions has been greatly enhanced by development of the CO2 laser. Using this modality, endoscopic access and precise tissue destruction are possible with minimal local inflammation and subsequent edema of the narrow airway. From October 1986 through October 1988, 26 patients underwent 96 laser procedures for excision of airway lesions, in 23 patients via bronchoscopy and in three patients via microlaryngoscopy. Ages ranged from 1 day to 20 years, with most patients under 2 years of age. Diagnoses included: laryngeal cysts (1); cystic hygroma (3); tumor (neurofibroma, 1) subglottic hemangioma (1); excision of airway granulation tissue (8); and tracheal stenosis (13, including subglottic stenosis in 9). Therapy of the offending lesion required from one to eight laser procedures (mean, 2.8), excluding one patient with congenital long-segment tracheal stenosis who required 24 laser treatments for repeated excision of tracheal granulation tissue. Most lesions responded to only one or two laser treatments. No bleeding or perforation occurred secondary to laser use. Use of the laser was responsible for salvaging the airway or simplifying management of the airway in 21 of the 26 patients. In three patients with cystic hygroma affecting the laryngeal structures as well as soft tissues of the neck, laser excision was performed to maintain upper airway patency with a tracheostomy for airway control. Two patients with critical subglottic stenosis initially responded to laser excision, but moved away from the area and developed recurrence of their subglottic stenosis requiring tracheostomy, because further laser treatment was either unavailable or was deferred in their new locale.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Division of Pediatric Surgery, University of Florida College of Medicine, Gainesville 32610.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

2125639

Citation

Bagwell, C E.. "CO2 Laser Excision of Pediatric Airway Lesions." Journal of Pediatric Surgery, vol. 25, no. 11, 1990, pp. 1152-6.
Bagwell CE. CO2 laser excision of pediatric airway lesions. J Pediatr Surg. 1990;25(11):1152-6.
Bagwell, C. E. (1990). CO2 laser excision of pediatric airway lesions. Journal of Pediatric Surgery, 25(11), 1152-6.
Bagwell CE. CO2 Laser Excision of Pediatric Airway Lesions. J Pediatr Surg. 1990;25(11):1152-6. PubMed PMID: 2125639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CO2 laser excision of pediatric airway lesions. A1 - Bagwell,C E, PY - 1990/11/1/pubmed PY - 1990/11/1/medline PY - 1990/11/1/entrez SP - 1152 EP - 6 JF - Journal of pediatric surgery JO - J. Pediatr. Surg. VL - 25 IS - 11 N2 - Treatment of life-threatening pediatric airway lesions has been greatly enhanced by development of the CO2 laser. Using this modality, endoscopic access and precise tissue destruction are possible with minimal local inflammation and subsequent edema of the narrow airway. From October 1986 through October 1988, 26 patients underwent 96 laser procedures for excision of airway lesions, in 23 patients via bronchoscopy and in three patients via microlaryngoscopy. Ages ranged from 1 day to 20 years, with most patients under 2 years of age. Diagnoses included: laryngeal cysts (1); cystic hygroma (3); tumor (neurofibroma, 1) subglottic hemangioma (1); excision of airway granulation tissue (8); and tracheal stenosis (13, including subglottic stenosis in 9). Therapy of the offending lesion required from one to eight laser procedures (mean, 2.8), excluding one patient with congenital long-segment tracheal stenosis who required 24 laser treatments for repeated excision of tracheal granulation tissue. Most lesions responded to only one or two laser treatments. No bleeding or perforation occurred secondary to laser use. Use of the laser was responsible for salvaging the airway or simplifying management of the airway in 21 of the 26 patients. In three patients with cystic hygroma affecting the laryngeal structures as well as soft tissues of the neck, laser excision was performed to maintain upper airway patency with a tracheostomy for airway control. Two patients with critical subglottic stenosis initially responded to laser excision, but moved away from the area and developed recurrence of their subglottic stenosis requiring tracheostomy, because further laser treatment was either unavailable or was deferred in their new locale.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0022-3468 UR - https://www.unboundmedicine.com/medline/citation/2125639/CO2_laser_excision_of_pediatric_airway_lesions_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0022-3468(90)90752-U DB - PRIME DP - Unbound Medicine ER -