Lasers in pediatric airway surgery: Current and future clinical applications

Abstract

In this review, we will discuss the clinical applications of lasers in pediatric airway surgery, the current state of the art, where the current technology is deficient, and the potential applications of novel laser systems.

The efficacy and safety of the flexible fiber CO2 laser delivery system in the endoscopic management of pediatric airway problems: Our long term experience

“…The use of such fibers in the pediatric airway, particularly the KTP laser, has been described as early as the mid-1990s [3]. However, the inherent disadvantages of these platforms, including the potential for increased scarring, greater penetration depth and increased thermal collateral damage, have precluded widespread use in pediatric airway surgery [4]. In contrast, the benefits of the carbon dioxide (CO2) laser, with its minimal depth of penetration (30 mm), absorption by water, and precise cutting ability, has been well established in head and neck surgery.…”

KTP laser ablation of extensive tracheal hemangiomas

“…CO 2 laser may not be delivered fiberoptically and the surgeon is limited to visualizing the tracheal lesions via the laser bronchoscope in cases of distal lesions [5]. CO 2 laser coagulative properties are inferior to those of the KTP laser and there has been a recent shift in airway surgery from CO 2 to KTP laser application for the treatment of airway hemangiomas [6,7]. In contrast to CO 2 laser, KTP laser may be delivered fiberoptically and its wavelength of 532 nm is in the visible range and is preferentially absorbed by hemoglobin, which makes the KTP laser well suited for the ablation of vascular lesions.…”

Applications for transoral robotic surgery in the pediatric airway

“…Moreover, the introduction of transoral laser microsurgery (TLM) has been a major advancement in endoscopic airway surgery. With regard to the pediatric airway, endoscopic laser surgery has been shown to be safe and efficacious because it allows for targeted treatment of a variety of airway pathologies . However, despite these technological advancements, several limitations can hinder successful endoscopic management of pediatric airway disease.…”