Laser-Assisted Management of Congenital and Acquired Pediatric Airway Disorders: Case Reports and Review of the Literature

Abstract

As laser surgery advances are made in the treatment of adult disorders, lasers are likewise increasingly being used in the treatment of pediatric otolaryngologic disorders. We evaluated outcomes of laser surgery in a group of infants and children with congenital and acquired airway disorders. The medical charts of infants and children who were treated for airway disorders between July 2005 and January 2007 at a tertiary care children's hospital were reviewed. Data included relevant history and physical examination, diagnostic work-up, management, and follow-up assessment. Seven patients who had laser surgery for airway lesions were identified. Two infants aged 3-12 wk had laryngomalacia, failure to thrive, and apnea. In one infant, CO(2) laser-assisted supraglottoplasty, in combination with microlaryngeal scissors, resulted in continuing weight gain in one infant at 15 mo after surgery, and no apnea episodes at 4 wk in the other infant. A 2-month-old infant underwent laser-assisted laryngeal cleft repair. Two patients diagnosed with recurrent respiratory papillomatosis at age 6-15 mo underwent multiple CO(2) and KTP laser ablations of laryngotracheal papillomas. Microdebrider removal of papillomas was initiated due to the large size of the papillomas. Two patients aged 5-11 y were burn victims with stridor, hoarseness, or difficulty breathing. After CO(2) ablation of subglottic stenosis and posterior glottic webs, voice and breathing improved and stridor resolved. Congenital and acquired airway lesions in ;infants and children can be treated with the laser. A combined approach with other techniques may be considered to decrease the duration of the procedure when applicable.