Diathermic coagulation and cutting in the endoscopic treatment of hypopharyngeal diverticula was replaced by CO2 laser evaporation. Endoscopic laser surgery was performed in 37 patients, with complete or almost complete relief in all cases. The rate of complications is low.
Endoscopic laser surgery for hypopharyngeal diverticula was performed in 28 patients. Complete relief of symptoms was achieved in 22, whilst the remaining patients improved considerably. The rate of complications was low. This new application of laser surgery proved to be a safe and reliable method of treatment for dysphagia caused by a hypopharyngeal diverticulum.
For endolaryngeal laser surgery an anaesthetic technique is required which provides the surgeon good access to the larynx. High frequency ventilation of the lungs using a FG 14 insufflation catheter covered by aluminium foil has proved to give a nearly optimal condition for the surgeon, while the fully paralyzed patient is very well ventilated. This has been used in more than 1000 patients, 200 of them have been treated by the laser beam in the airway. A method of total intravenous anaesthesia is described using short acting drugs. This way early awakening after surgery in the airways prevents aspiration of blood or debris into the lungs.
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