Use of the carbon dioxide laser for tracheobronchial lesions in children

Phayvanh P. Sjogren, James D Sidman

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Importance: Obstructing tracheobronchial diseases in children can be treated by a variety of techniques. The nonfiberoptic delivery of the carbon dioxide laser coupled to a rigid bronchoscope has rarely been described for this purpose and has unique advantages over other treatment methods. Objectives: To report the indications, safety, efficacy, and limitations of the carbon dioxide laser delivered through a rigid bronchoscope for tracheobronchial lesions in the pediatric population. Design: Case series of patients undergoing treatment for tracheobronchial lesions at a single institution from December 2, 2001, through December 14, 2011. Setting: Tertiary care children's hospital. Participants: Seventeen patients aged 3 months to 17 years with endotracheal and endobronchial disease. Intervention: Carbon dioxide laser treatment through a rigid bronchoscope. Main Outcome Measures: Reduction in tumor burden or improvement of ventilation. Results: A total of 234 laser bronchoscopies were performed on 17 patients. Mean operative time was 29 (range, 2-89) minutes. Blood loss and complications were minimal. Sixteen patients received carbon dioxide laser delivered through a rigid bronchoscope with a proximal coupler or flexible fiber. The most common indication was tracheobronchial granulation tissue (n=10), followed by prolapsed cartilage causing tracheal obstruction (n = 3), recurrent respiratory papillomatosis (n=2), and granular cell tumor (n=1). Of these patients, 15 (94%) underwent successful treatment. One patient was treated electively with the Nd:YAG laser owing to a vascular malformation. Conclusions and Relevance: The carbon dioxide laser delivered through a rigid bronchoscope is a suitable tool for managing nonvascular endotracheal and endobronchial lesions in the pediatric population. Its unique wavelength properties offer a safe, effective alternative to other lasers and open resection.

Original languageEnglish (US)
Pages (from-to)231-235
Number of pages5
JournalJAMA Otolaryngology - Head and Neck Surgery
Volume139
Issue number3
DOIs
StatePublished - Mar 2013

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