Indications of the carbon dioxide laser in tracheobronchial pathology of the infant and young child: 14 cases

E, Garabédian; Denoyelle, Françoise; Grimfeld, A; Lacombe, Hervé

doi:10.1288/00005537-199011000-00018

Cited by 9 publications

(3 citation statements)

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“…Several groups have reported their experience with the CO 2 laser in tracheobronchial pathology in children [1,3,4,6,17]. Numerous other techniques are or have been used for the endoscopic treatment of tracheobronchial lesions: microforceps, thermocoagulation, cryotherapy, balloon dilatations and other types of lasers, such as potassium titanyl phosphate [2,9,11,13,14,15,19].…”

Section: Discussionmentioning

confidence: 99%

Use of the carbon dioxide laser for tracheobronchial pathology in children

Denis

Wagner

Denoyelle

et al. 2000

European Archives of Oto-Rhino-Laryngology

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The carbon dioxide (CO2) laser has been used to treat tracheobronchial pathology for more than 20 years. It was initially employed in adults and now has been found to be useful in the treatment of certain lesions in children. We present our experience with this technique in 30 patients treated with a CO2 bronchoscopic laser from 1987 to 1995 in the Ear, Nose, and Throat Department of Armand Trousseau Hospital. Four different types of pathologies have been successfully treated with the laser: selective cases of tracheobronchial stenosis following trauma and/or secondary to neonatal ventilation, posttraumatic tracheobronchial granuloma (due to foreign bodies or tracheotomies), tracheobronchial granulomas of infectious origin (tuberculosis), and selective cases of tracheobronchial tumor.

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Section: Discussionmentioning

confidence: 99%

Use of the carbon dioxide laser for tracheobronchial pathology in children

Denis

Wagner

Denoyelle

et al. 2000

European Archives of Oto-Rhino-Laryngology

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“…Incidents such as airway wall perforation and exsanguinating hemorrhage from carbon dioxide laser surgery are extremely rare in the pediatric literature. 22 The most feared complication of laser bronchoscopy remains major airway fire. Combustible materials are nonmetallic and include plastic suction catheters, polyvinyl endotracheal tubes, and flexible fiberoptic bronchoscopes.…”

Section: Commentmentioning

confidence: 99%

“…22 The most feared complication of laser bronchoscopy remains major airway fire. Combustible materials are nonmetallic and include plastic suction catheters, polyvinyl endotracheal tubes, and flexible fiberoptic bronchoscopes.…”

mentioning

confidence: 99%

Use of the Carbon Dioxide Laser for Tracheobronchial Lesions in Children

Sjogren

Sidman²

2013

JAMA Otolaryngol Head Neck Surg

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Obstructing tracheobronchial diseases in children can be treated by a variety of techniques. The nonfiberoptic delivery of the carbon dioxide laser coupled to a rigid bronchoscope has rarely been described for this purpose and has unique advantages over other treatment methods.Objectives: To report the indications, safety, efficacy, and limitations of the carbon dioxide laser delivered through a rigid bronchoscope for tracheobronchial lesions in the pediatric population.Design: Case series of patients undergoing treatment for tracheobronchial lesions at a single institution from December 2, 2001, through December 14, 2011.Setting: Tertiary care children's hospital.Participants: Seventeen patients aged 3 months to 17 years with endotracheal and endobronchial disease.Intervention: Carbon dioxide laser treatment through a rigid bronchoscope.Main Outcome Measures: Reduction in tumor burden or improvement of ventilation.Results: A total of 234 laser bronchoscopies were performed on 17 patients. Mean operative time was 29 (range, 2-89) minutes. Blood loss and complications were minimal. Sixteen patients received carbon dioxide laser delivered through a rigid bronchoscope with a proximal coupler or flexible fiber. The most common indication was tracheobronchial granulation tissue (n=10), followed by prolapsed cartilage causing tracheal obstruction (n=3), recurrent respiratory papillomatosis (n=2), and granular cell tumor (n=1). Of these patients, 15 (94%) underwent successful treatment. One patient was treated electively with the Nd:YAG laser owing to a vascular malformation. Conclusions and Relevance:The carbon dioxide laser delivered through a rigid bronchoscope is a suitable tool for managing nonvascular endotracheal and endobronchial lesions in the pediatric population. Its unique wavelength properties offer a safe, effective alternative to other lasers and open resection.

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