Treatment of laryngeotracheal papillomatosis with the CO2 and Nd:YAG laser
Papillomas are the most common benign neoplasms of the larynx and trachea. There are two types with different biological behavior, both caused by the human papilloma virus: the form that usually manifest itself in adults as a solitary, rarely recurring lesion, whereas one form that manifests in children and adults. It involves multiple lesions with a tendency to spread and recur. There is still no alternative to repeated surgical removal of the papillomas. In a retrospective study the results of laser surgery are compared with the results of instrumental removal of papillomas. The larynges were treated with the CO2 laser applied via high-precision micromanipulators combined with different scanner systems. In cases where the disease has spread into the cervical trachea, the papilloma foci were exposed by special subglottoscopes prior to transglottic removal with the CO2 laser via the operating microscope. The Nd:YAG laser applied through a jet ventilation tracheoscope via optical fibers has proven useful for involvement of the intrathoracic trachea. The use of the laser has not reduce the recurrency rate but the rate of late complications such as anterior synechia. Furthermore in extensive disease laser therapy enables a controlled bloodless removal even in the thoracic trachea and bronchi.
This paper was published in SPIE Proceedings Vol. 4166
Laser Florence '99: A Window on the Laser Medicine World, Leonardo Longo; Alfons G. Hofstetter; Mihail-Lucian Pascu; Wilhelm R. Waidelich, Editors, pp.182-184