MedicineSurgeryOtolaryngologic SurgeryPediatric Oral SurgeryPediatric OtolaryngologyAirway SurgeryEndoscopic Sinus SurgeryLaser SurgeryPediatric Airway ReconstructionTracheal SurgeryCarbon Dioxide Laser SurgeryChoanal StenosisNd:yag Laser TreatmentOral Cavity LesionsOral PapillomaSubglottic HemangiomaSubglottic Stenosis RepairSubglottic Stenosis Surgery
OBJECTIVE: The aim of this study was to review the role of the holmium:YAG laser in the management of paediatric airway disorders. METHOD: Twenty-six paediatric patients underwent 42 airway procedures between June 1993 and August 1996 in a tertiary care centre. A case series design was used. OUTCOME MEASURES: Safety, precision, hemostasis, bone-cutting properties, and accessibility of the lesion to the equipment were compared to standard therapies. Postoperative outcomes were then compared to standard therapies. RESULTS: Eight patients underwent correction of choanal atresia or revision, 10 patients underwent functional endoscopic sinus surgery, 3 underwent excision of tracheal granuloma, 2 underwent excision of tracheal web or revisions, 1 underwent excision of subglottic stenosis and bronchial stenosis, 1 underwent excision hemangioma of the tongue, and 1 underwent excision papilloma of the oral cavity. One patient in 42 procedures suffered a surgical complication. Our early success rates are comparable to other series using the carbon dioxide laser or cold instruments. CONCLUSION: The holmium:YAG laser is a safe, effective tool in the treatment of paediatric airway disorders and offers the advantage of a flexible fibre-optic system, good hemostasis, and better bone-cutting characteristics compared to the carbon dioxide laser, which is in widespread clinical use.