Prevention of laryngeal stenosis in Co2 laser management of recurrent respiratory papillomatosis

Abstract Laryngeal papillomatosis is a benign disease in the larynx but with the potential to develop into significant complications as a result of its high recurrence rate. CO2 laser and radiofrequency controlled ablation (coblation) have been used to treat recurrent respiratory papillomatosis, but detailed comparisons of their respective treatment outcomes are not fully investigated. This retrospective study examines the procedure time, time interval between interventions, blood loss during operation, post-operative complications and pain scores among patients who received either CO2 laser or radiofrequency coblation interventions for laryngotracheal recurrent respiratory papillomatosis. Compared with CO2 laser intervention, radiofrequency coblation significantly reduced operation time, time interval between interventions, blood loss during operation and number of times bipolar electrocoagulation needed in each procedure. Post-operatively, pain scores after radiofrequency coblation were significantly lower than those after CO2 laser intervention. Incidence rates of post-operative complications, in terms of palate pharyngeal mucosa damage, bleeding and subcutaneous emphysema, were also significantly reduced after radiofrequency coblation. Low-temperature radiofrequency coblation is a superior intervention compared with CO2 laser against laryngotracheal recurrent respiratory papillomatosis.

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Variants of surgical treatment of chronic post-intubation laryngeal stenosis in children

Voprosy praktičeskoj pediatrii ◽

10.20953/1817-7646-2021-2-7-13 ◽

2021 ◽

Vol 16 (2) ◽

pp. 2-13

Author(s):

V.V. Vavin ◽

◽

I.I. Nazhmudinov ◽

T.I. Garashchenko ◽

O.V. Karneeva ◽

...

Keyword(s):

Co2 Laser ◽

Scar Tissue ◽

Laryngeal Stenosis ◽

Recurrent Stenosis ◽

Silicone Stent ◽

Laryngeal Cartilages ◽

Surgical Tactics ◽

Post Intubation ◽

Autologous Grafts ◽

Preoperative Examination

Objective. To evaluate the effectiveness of a surgical tactics used for the treatment of children with chronic post-intubation laryngeal stenosis depending on the condition of their laryngeal cartilages. Patients and methods. We treated 47 children with chronic post-intubation laryngeal stenosis. Preoperative examination included endoscopy and computed tomography (CT) of the larynx and trachea. We evaluated the condition of their laryngeal cartilages in order to choose an optimal surgical tactics. Children with intact laryngeal cartilages (n = 20) have undergone endolaryngeal microsurgery using a CO2 laser. This method caused minimal injury due to submucosal excision of scar tissue, which enabled wound coverage with mucous microflaps to prevent recurrent stenosis. Surgery for extensive stenosis in the middle portion of the larynx was associated with a risk of recurrent scarring. In our study, we prevented it by using endografts during 21 days. However, patients with lesions in the subglottic larynx still had a high risk of recurrent stenosis (5 out of 12 patients) even if there was no evidence of damage to the laryngeal cartilages. Results. Twenty-seven patients with laryngeal post-intubation stenosis with lesions to the laryngeal cartilages detected before surgery have undergone extralaryngeal laryngotracheoplasty. Eighteen children have undergone laryngofissure with subsequent stenting between 6 and 18 months with a T-shaped silicone stent. Nine patients have undergone single-stage laryngotracheoplasty with autologous grafts. Conclusion. The methods used in this study have demonstrated high effectiveness, while the use of grafts reduced the number of stages of surgery and its duration. Key words: laryngotracheoplasty in children, laryngeal microsurgery, complications of tracheal intubation in children, chronic laryngeal stenosis, cartilage autologous grafts, CO2 laser

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Innovative Autostatic Laryngeal Stent Used in the Treatment of Laryngeal Stenosis

Materiale Plastice ◽

10.37358/mp.18.2.4991 ◽

2018 ◽

Vol 55 (2) ◽

pp. 188-189

Author(s):

Razvan Hainarosie ◽

Irina Gabriela Ionita ◽

Mura Hainarosie ◽

Catalina Pietrosanu ◽

Dragos Cristian Stefanescu ◽

...

Keyword(s):

Co2 Laser ◽

Favorable Outcome ◽

Laryngeal Stenosis ◽

Laser Resection ◽

Biocompatible Material ◽

Multiple Stages

Laryngeal stenosis represents a serious and challenging condition in the field of otorhinolaryngology. The management of laryngeal stenosis is performed in multiple stages, and numerous surgeries can be necessary to obtain a favorable outcome. We present a specially designed laryngeal stent suitable for patients with stenosis of the larynx, that can be used after CO2 laser resection. The particular shape of the device, the biocompatible material and the autostatic propriety are some important characteristics that improve the tolerability of patients to the stent. The device has multiple advantages that make it a proper therapy method for selected patients with stenosis of the larynx.

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CO2 Laser Surgery for Laryngeal Stenosis

Nippon Laser Igakkaishi ◽

10.2530/jslsm1980.17.supplement_157 ◽

1996 ◽

Vol 17 (Supplement) ◽

pp. 157-161

Author(s):

Akihiko Takasu ◽

Shigenobu Iwata ◽

Kazuo Sakurai ◽

Yoshihi Iwata

Keyword(s):

Co2 Laser ◽

Laser Surgery ◽

Laryngeal Stenosis ◽

Co2 Laser Surgery

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Laryngeal papillomatosis

10.1093/med/9780198834281.003.0079 ◽

2018 ◽

Author(s):

Mike Saunders

Keyword(s):

Outcome Measures ◽

Co2 Laser ◽

Recurrent Respiratory Papillomatosis ◽

Laryngeal Papillomatosis

This chapter discusses Strong, Vaughan, Cooperband, Healy, and Clemente’s paper on recurrent respiratory papillomatosis management with the CO2 laser including the design of the study (outcome measures, results, conclusions, and a critique).

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The treatment of laryngeal stenosis using the CO2 laser

Clinical Otolaryngology ◽

10.1111/j.1365-2273.1986.tb02006.x ◽

2009 ◽

Vol 11 (3) ◽

pp. 145-148

Author(s):

J. A. S. CARRUTH ◽

N. J. MORGAN ◽

M. S. NIELSEN ◽

J. J. PHILLIPPS ◽

A. C. WAINWRIGHT

Keyword(s):

Co2 Laser ◽

Laryngeal Stenosis

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Utility of CO2 laser in endolaryngeal surgery for postintubation laryngeal stenosis in children

Voprosy praktičeskoj pediatrii ◽

10.20953/1817-7646-2019-5-34-38 ◽

2019 ◽

Vol 14 (5) ◽

pp. 34-38

Author(s):

V.V. Vavin ◽

◽

Kh.Sh. Davudov ◽

T.I. Garashchenko ◽

A.S. Yunusov ◽

...

Keyword(s):

Co2 Laser ◽

Laryngeal Stenosis ◽

Endolaryngeal Surgery

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Recurrent Respiratory Papillomatosis (RRP)—Juvenile Onset

Clinical medicine Oncology ◽

10.4137/cmo.s698 ◽

2008 ◽

Vol 2 ◽

pp. CMO.S698 ◽

Cited By ~ 1

Author(s):

Sara W. Dyrstad ◽

Krishna A. Rao

Keyword(s):

Local Excision ◽

Co2 Laser ◽

Chemotherapy Regimen ◽

Pegylated Interferon ◽

Recurrent Respiratory Papillomatosis ◽

Treatment Modalities ◽

Juvenile Onset ◽

Oral Methotrexate ◽

Treatment Regimens

In this article, we describe the treatment of long standing juvenile-onset recurrent respiratory papillomatosis (JORRP) with eventual transformation to carcinoma in a patient who lived to the age of 73. Treatment modalities consisted of bronchoscopy and local excision initially. Later, YAG and CO2 laser debulking were used. Radiotherapy, chemotherapy with carboplatin (300 mg/m2) and 5-FU (600 mg/m2), oral methotrexate (5–7.5 mg/week), pegylated Interferon, indole-3-carbamide, and intralesional cidofovir were also utilized in the treatment of this patient. Except for methotrexate, each of the treatment regimens used in this patient, initially decreased growth of the papillomas and improved symptoms experienced by the patient. Interestingly, we found that this patient's long standing JORRP initially responded to a chemotherapy regimen of 4 cycles of carboplatin (300 mg/m2) and 5-FU (600 mg/m2) as well. Ultimately, the disease became resistant to all forms of treatment and progressed. The patient eventually succumbed to the disease after an approximate 77 year course.

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