Complications of Laser Surgery for Recurrent Respiratory Papillomatosis

During an 8-year period, 66 patients with recurrent respiratory papillomatosis underwent 890 laser microlaryngoscopy procedures. A retrospective analysis of immediate and delayed complications occurring with laser microlaryngoscopy in the treatment of these patients revealed that complications secondary to anesthetic technique and laser methodology were remarkably low (0.3%). Delayed complications of tissue injury (36% of pediatric patients and 17% of adult patients) were more frequent and included anterior glottic webbing, interarytenoid scarring and arytenoid fixation, vocal fold fibrosis, and generalized endolaryngeal glottic stenosis. All patients were evaluated by direct visualization and recording at the time of the operative procedure, as well as by review of intraoperative photographs. A smaller group of patients underwent analysis of voice recordings and laryngeal stroboscopy. The frequency and severity of tissue injury was higher in the patients with more severe disease who underwent multiple operative procedures.

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Laryngeal Laser Surgery for Recurrent Respiratory Papillomatosis, Cancer and Dysplasia: Operating Room and Office

Perspectives on Voice and Voice Disorders ◽

10.1044/vvd19.2.74 ◽

2009 ◽

Vol 19 (2) ◽

pp. 74-83

Author(s):

Steven M. Zeitels ◽

Robert E. Hillman

Keyword(s):

Laser Treatment ◽

Operating Room ◽

Laser Surgery ◽

Vocal Fold ◽

Recurrent Respiratory Papillomatosis ◽

Ktp Laser ◽

Thulium Laser ◽

Skill Sets ◽

The Cost ◽

Angiolytic Laser

Abstract Since their introduction in laryngology over 30 years ago, lasers have facilitated critically-important innovations that have now evolved into office-based surgery. Recent advances include the application of angiolytic lasers that treat vocal fold lesions by ablating vasculature and the use of the thulium laser as a more efficient and versatile tissue dissector. In our experience, the 532nm pulsed KTP laser has emerged thus far as the optimal angiolytic laser to treat vocal-fold lesions both in the operating room and in the clinic setting. Despite the fact that the skill-sets to adopt office-based laser treatment are an easy transition for most laryngological surgeons, the primary impediment to widespread adoption is the cost of the technology. Furthermore, critical development of these new lasers will occur with broader use of these lasers in other surgical disciplines, which should diminish costs for all surgeons and thereby promote better outcomes for individuals with voice disorders.

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CIScoSI Study [Children Immunization Status and cases of Systemic Illness]

Medical & Clinical Research ◽

10.33140/mcr.03.03.02 ◽

2018 ◽

Vol 3 (3) ◽

Keyword(s):

Infectious Diseases ◽

East Asia ◽

Pediatric Patients ◽

Severe Disease ◽

Tertiary Care ◽

Immunization Coverage ◽

South East Asia ◽

Immunization Status ◽

Tertiary Care Hospitals ◽

Total Coverage

To determine the immunization status of pediatric patients under age of 5 years visiting pediatric department of tertiary care hospitals in South East Asia. The aim of this study was to appreciate the awareness and implementation of vaccination in pediatric patients who came into pediatric outpatient Department with presenting complain other than routine vaccination. we can also know the count of patients who do not complete their vaccination after birth. we can differentiate between vaccinated and unvaccinated patients and incidence of severe disease in both groups. Immunization is a protective process which makes a person resistant to the harmful diseases prevailing in the community, typically by vaccine administration either orally or intravenously. It is proven for controlling and eliminating many threatening diseases from the community. WHO report that licensed vaccines are available for the prevention of many infectious diseases. After the implementation of effective immunization the rate of many infectious diseases have declined in many countries of the world. South-East Asia is far behind in the immunization coverage. An estimated total coverage is 56%-88% for a fully immunized child, which is variable between countries. Also the coverage is highest for BCG and lowest for Polio.

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Incidence of Acute and Chronic Post-Thoracotomy Pain in Pediatric Patients

Children ◽

10.3390/children8080642 ◽

2021 ◽

Vol 8 (8) ◽

pp. 642

Author(s):

Giuliano Marchetti ◽

Alessandro Vittori ◽

Fabio Ferrari ◽

Elisa Francia ◽

Ilaria Mascilini ◽

...

Keyword(s):

General Anesthesia ◽

Pediatric Patients ◽

Pain Syndrome ◽

Intercostal Nerve ◽

Anesthetic Technique ◽

Intercostal Nerve Block ◽

Thoracic Epidural ◽

Burning Pain ◽

Significant Difference ◽

Group B

We studied acute and chronic pain in pediatric patients who underwent thoracotomy for benign disease with a follow-up of at least three months. A telephone interview investigated about the presence of pain and the analgesic therapy in progress. The results were compared with the anesthetic technique, postoperative pain and the adequacy of pain therapy, both during the first week after surgery and at the time of interview. Fifty-six families consented to the study. The mean age of the children at surgery was 2.9 ± 4.5 years, while at the time of the interview was 6.5 ± 4.4 years. We performed different anesthetic strategies: Group A: general anesthesia (36 pts); Group B: general anesthesia and thoracic epidural (10 pts); Group C: general anesthesia and intercostal nerve block (10 pts). During the immediate postoperative period, 21 patients (37.5%) had at least one painful episode. At the time of interview, 3 children (5.3%) had moderate chronic neuropathic (burning) pain on surgical scar. There was no statistically significant difference between the type of anesthesia and the incidence and severity of acute post-operative pain. Despite its limitations, this study confirms the low incidence of chronic post-thoracotomy pain syndrome in children.

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Con: Regional anesthesia is not an important component of the anesthetic technique for pediatric patients undergoing cardiac surgical procedures

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/jcan.2002.125116 ◽

2002 ◽

Vol 16 (3) ◽

pp. 379-381 ◽

Cited By ~ 4

Author(s):

Helen Holtby

Keyword(s):

Regional Anesthesia ◽

Surgical Procedures ◽

Pediatric Patients ◽

Cardiac Surgical Procedures ◽

Anesthetic Technique

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Value of Preoperative Chest X-ray Examinations in Children

PEDIATRICS ◽

10.1542/peds.60.5.669 ◽

1977 ◽

Vol 60 (5) ◽

pp. 669-672

Author(s):

Shashikant M. Sane ◽

Robert A. Worsing ◽

Cornelius W. Wiens ◽

Rajiv K. Sharma

Keyword(s):

Prospective Study ◽

Pediatric Patients ◽

Anesthetic Technique ◽

Chest Film ◽

X Ray ◽

Patients Âgés ◽

Chest X Ray ◽

A Prospective Study ◽

Preoperative Chest

To assess the value of routine preoperative chest x-ray films in pediatric patients, a prospective study of 1,500 patients, ages newborn to 19 years, was undertaken. Of all the patients, 7.5% demonstrated at least one roentgenographic abnormality, with 4.7% of the patients demonstrating a totally unsuspected significant roentgenographic anomaly. In 3.8% of the patients, surgery was either postponed or cancelled or the anesthetic technique was altered as a result of the roentgenographic finding. It is believed that the routine preoperative chest film is justified if the film is evaluated before surgery and the results clinically followed up.

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Postoperative Inhaled Steroids Following Glottic Airway Surgery Reduces Granulation Tissue Formation

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211065805 ◽

2021 ◽

pp. 000348942110658

Author(s):

Alison N. Hollis ◽

Ameer Ghodke ◽

Douglas Farquhar ◽

Robert A. Buckmire ◽

Rupali N. Shah

Keyword(s):

Granulation Tissue ◽

Laser Surgery ◽

Vocal Fold ◽

Inhaled Corticosteroids ◽

Surgical Removal ◽

Tissue Formation ◽

Granulation Tissue Formation ◽

Inhaled Steroids ◽

Transoral Laser Surgery ◽

Airway Surgery

Objectives: Transoral laser surgery for glottic stenosis (transverse cordotomy and anteromedial arytenoidectomy (TCAMA)) is often complicated by granulation tissue (GT) formation. GT can cause dyspnea and may require surgical removal to alleviate airway obstruction. Inhaled corticosteroids (ICS) have been shown to reduce benign vocal fold granulomas, however its use to prevent GT formation has not been described. We aimed to analyze the effect of immediate postoperative ICS on GT formation in patients undergoing transoral laser surgery for glottic stenosis. Methods: A retrospective analysis of patients that had transoral laser surgery for glottic stenosis from 2000 to 2019 was conducted. Surgical instances were grouped into those that received postoperative ICS and those that did not. Demographics, diagnosis, comorbidities, intraoperative adjuvant therapy, and perioperative medications were collected. Differences in GT formation and need for surgical removal were compared between groups. A multivariate exact logistic regression model was performed. Results: Forty-four patients were included; 16 required 2 glottic airway surgeries (60 surgical instances). Of the 23 instances where patients received immediate postoperative ICS, 0 patients developed GT; and of the 37 instances that did not receive postoperative ICS, 15 (40.5%) developed GT ( P < .0001). Eight (53.3%) of these cases returned to the OR for GT removal. ICS use was solely associated with the absence of GT formation ( P = .042) in the multivariate analysis. Conclusions: Immediate postoperative use of ICS seems to be a safe and effective method to prevent granulation tissue formation and subsequent surgery in patients following transoral laser airway surgery for glottic stenosis.

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Indirect Microsurgery of the Vocal Folds - Videostroboscopy vs. Microstroboscopy

Ear Nose & Throat Journal ◽

10.1177/014556139307200207 ◽

1993 ◽

Vol 72 (2) ◽

pp. 134-141 ◽

Cited By ~ 6

Author(s):

Zoran Milutinović

Keyword(s):

Laser Surgery ◽

Vocal Fold ◽

Vocal Folds ◽

Surgical Approaches ◽

Surgical Trauma ◽

Benign Lesions ◽

Functional Control ◽

Microlaryngeal Surgery ◽

Surgical Manipulation ◽

Vocal Fold Surgery

In spite of the great significance of direct microlaryngeal surgery (DML), the inadequacies of this technique are evident. In order to avoid surgical trauma and introduce functional control during surgery, indirect microstroboscopic (IMS) and indirect videostroboscopic surgery (IVS) of the vocal folds are advocated. Both of these meet most criteria for surgical work in this field. The aim of this work was to make a comparative study of these techniques. The study is based on 603 operations conducted for benign lesions of the vocal folds. We are of the opinion that indirect vocal fold surgery for small benign lesions has significant advantages when compared with the conventional microlaryngoscopy, including laser surgery, which was proven elsewhere. When comparing these two indirect surgical approaches, the principal advantages of IVS surgery over the IMS method are easier surgical manipulation and better view. With respect to other areas of comparison, these techniques are quite similar. As complementary methods to conventional microlaryngoscopy, we believe that both IVS and IMS surgery should be used in practice.

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