Treatment of severe subglottic stenosis in children with the CO₂ laser. A preliminary report on a few successful cases

Abstract

Subglottic stenosis in children is difficult to resect even with the CO₂ laser. The smallest laser bronchoscope is usually too large to pass through the glottis. In cases where it is possible, the precision may not suffice. A micromanipulator used together with a laryngoscope will permit a far better control of the laser beam. The commercially available instruments are not sufficiently small for use in a small stenotic larynx. As only small parts of the stenosis should be removed at one time, there has been a need for delicate instruments to protect parts of the laryngeal interior and at the same time permit access to the nether area of the subglottic region. Instruments designed by the author is described and the preliminary results of hitherto five consecutive cases are reported. Ages at the beginning of the treatment varies from 2 months to 4 years and 4 months. The most severe case has been treated six times. Three children are living without breathing problems. One child is about to be decannulated, and the treatment has just begun in the most recent case. The observation time after treatment is 2 years at most.

Key Words:

• Larynx
• Laryngeal stenosis
• Laser surgery
• Instruments