The Holmium:YAG Laser-Assisted Otolaryngologic Procedures

Holmium Laser for Endoscopic Treatment of Benign Tracheal Stenosis

“…Gleich reported the most varied experience with the holmium laser when he reported on 37 procedures including endoscopic sinus surgery, dacryocystorhinostomy, treatment of choanal stenosis, ablation of obstructive tracheopathia osteoplastica, and removal of a sphenoid sinus mucocele without any complications related to laser use. 13 Fong reported several cases of distal airway (tracheobronchial) use of the holmium laser in a report of 26 pediatric patients undergoing 42 airway procedures. 19 Fong's experience was over a broad range of procedures, including correction of choanal atresia, endoscopic sinus surgery, tracheal granuloma excision, tracheal web excision, subglottic stenosis excision, hemangioma of the tongue excision, and oral cavity papilloma excision.…”

“…The safety of the holmium laser has been shown previously, and has been borne out in our study. 13 19 25 No patients suffered vocal cord damage or changes beyond those considered to be from intubation. All patients with post-intubation vocal cord changes had returned to their baselines within one month.…”

Optimal Positioning Techniques With Fiberoptic Laser Excision in the Treatment of Congenital Tongue Base Lesions

“…10 Holmium-YAG laser has a wavelength of 2100 nm and is absorbed by water to a depth of 0.4 mm. 11,12 CO 2 laser has a wavelength of 10,600 nm and is absorbed by water to a depth of 0.5 mm. KTP and Holmium-YAG have low, lateral, thermal penetration of about 0.4 mm, yet have excellent coagulation properties; thus, they are ideal for excising deep lesions in vascular areas such as the pediatric oropharynx.…”

“…CO 2 laser has a wavelength of 10,600 nm and is absorbed by water to a depth of 0.5 mm. KTP and Holmium‐YAG have low, lateral, thermal penetration of about 0.4 mm, yet have excellent coagulation properties; thus, they are ideal for excising deep lesions in vascular areas such as the pediatric oropharynx . Due to the absorption wavelengths and depth of penetration, excision proceeded in a quick and precise manner, avoiding unnecessarily long anesthetic for the patient.…”

Tracheopathia Osteochondroplastica

“…Others have attempted surgical or bronchoscopic removal, laser ablation (CO 2 or holmium: yttrium-aluminum-garnet [Ho:YAG]), cryotherapy, and external beam irradiation in cases causing significant airway compromise. 4,5,25,[40][41][42] While the incidence rates of TPO remain uncertain, its occurrence is probably more common than currently recognized. Awareness of this entity may help explain cases of persistent cough, exertional dyspnea, recurrent episodes of hemoptysis, and persistent pulmonary infections, especially when other presumptive causes of these symptoms have been treated or ruled out.…”