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Abstract

Lower tracheal and endobronchial lesions represent a difficult management problem. While there has been some success in the treatment of these lesions with the carbon dioxide laser, the limitations of its delivery system have restricted its use in infants and neonates. The potassium titanyl phosphate (KTP) laser, transmitted via a flexible quartz fiber, can be precisely manipulated even through rigid pediatric bronchoscopes as small as 3.0 mm. In addition, the Hopkins telescopic lens may be used to improve visualization and control. We report our experience using the KTP laser to treat 15 pediatric patients with tracheal and endobronchial lesions. The nature of the lesions, the details of the technique, and the results are presented.

Keywords

endobronchial lesions endoscopy potassium titanyl phosphate laser tracheal lesions

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References

Ossoff

Tucker

Werkhaven

. Neonatal and pediatric microsubglottiscope set. Ann Otol Rhinol Laryngol 1991; 100: 325–6.

Strong

Jako

Polanyi

Wallace

. Laser surgery in the aerodigestive tract. Am J Surg 1973; 126: 529–33.

Strong

Vaughan

Polanyi

Wallace

. Bronchoscopic carbon dioxide laser surgery. Ann Otol Rhinol Laryngol 1974; 83: 769–76.

Healy

McGill

Simpson

Strong

. The use of the carbon dioxide laser in the pediatric airway. J Pediatr Surg 1979; 14: 735–40.

Ossoff

Duncavage

Gluckman

. Universal endoscopic coupler for bronchoscopic CO₂ laser surgery: a multi-institutional clinical trial. Otolaryngol Head Neck Surg 1985; 93: 824–30.

Komisar

Ruben

. Use of the carbon dioxide laser in pediatric otolaryngologic disease. NY State J Med 1981; 81: 1761–4.

Garabedian

E-N

Denoyelle

Grimfeld

LaCombe

. Indications of the carbon dioxide laser in tracheobronchial pathology of the infant and young child: 14 cases. Laryngoscope 1990; 100: 1225–8.

Werkhaven

Maddern

Stool

. Posttracheotomy granulation tissue managed by carbon dioxide laser excision. Ann Otol Rhinol Laryngol 1989; 98: 828–30.

Simpson

Strong

Healy

Shapshay

Vaughan

. Predictive factors of success or failure in the endoscopic management of laryngeal and tracheal stenosis. Ann Otol Rhinol Laryngol 1982; 91: 384–8.

10.

Ossoff

Tucker

Jr Duncavage

Toohill

. Efficacy of bronchoscopic carbon dioxide laser surgery for benign strictures of the trachea. Laryngoscope 1985; 95: 1220–3.

11.

Shapshay

Davis

Vaughan

Norton

Strong

Simpson

. Palliation of airway obstruction from tracheobronchial malignancy: use of the CO₂ laser bronchoscope. Otolaryngol Head Neck Surg 1983; 91: 615–9.

12.

Gillis

Shapshay

Vaughan

Simpson

Davis

Strong

. Laser bronchoscopic surgery. J Otolaryngol 1983; 12: 217–22.

13.

Castro

Saxton

Ward

. Flexible Nd:YAG laser palliation of obstructive tracheal metastatic malignancies. Laryngoscope 1990; 100: 1208–14.

14.

Lobe

. The KTP/532 laser for pediatric endobronchial surgery. KTP/532 clinical update. No. 10, April 1988.

15.

Shapshay

Beamis

Jr Dumon

J-F

. Total cervical tracheal stenosis: treatment by laser, dilation, and stenting. Ann Otol Rhinol Laryngol 1989; 98: 890–5.

16.

Dumon

Reboud

Garbe

Aucomte

Meric

. Treatment of tracheobronchial lesions by laser photoresection. Chest 1982; 81: 278–84.

17.

Healy

. Subglottiscope. Trans Am Bronchoesophagol Assoc 1987: 130.

18.

Ossoff

Duncavage

Dere

. Microsubglottoscopy: an expansion of operative microlaryngoscopy. Otolaryngol Head Neck Surg 1991; 104: 842–8.

19.

Fried

Mallampati

Caminear

. Comparative analysis of the safety of endotracheal tubes with the KTP laser. Laryngoscope 1989; 99: 748–51.

20.

Andrews

Myer

III Cotton

. Alternative management for laryngeal and tracheobronchial lesions: the Bugbee electrode. Otolaryngol Head Neck Surg 1990; 103: 841.

Treatment of Tracheal and Endobronchial Lesions with the Potassium Titanyl Phosphate Laser

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