Flash pump dye laser treatment of laryngeal papillomas
Flash pump dye laser treatment of laryngeal papillomas
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DOI：
10.1177/000348949810701201
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发表时间：
1998-12-01
影响因子：
1.4
通讯作者：
Schaeffer, R
中科院分区：
文献类型：
--
作者：
Bower, CM;Waner, M;Schaeffer, R
为了评价闪光泵浦染料(FPD)激光治疗喉乳头状瘤的可行性和安全性，我们在一家三级保健儿童医院进行了一项前瞻性非随机试验，比较了FPD和二氧化碳激光治疗喉乳头状瘤的疗效。9名2-20岁的严重复发性喉乳头状瘤患者被纳入研究。所有患者均接受了8W连续或脉冲能量的CO2激光治疗左侧喉乳头状瘤。用8~12J的FPD激光对右半喉进行治疗，激光脉冲强度为12~77个脉冲，通过定制的90度激光纤维。使用了乳头状瘤的烫伤和紫疹的终点。主要的观察指标是使用FPD激光的安全性和易操作性，以及根据术后2周和下一次激光手术的目测缩小乳头状瘤大小。其中7例用平板激光照射1次，2例照射2次。术中无并发症发生。1例患者术后早期出现前庭症状。没有患者描述更多的不适，5名患者描述他们的声音与之前的二氧化碳激光手术后相同或更好。术后2周，5例患者FPD照射侧乳头状瘤体积缩小90%或以上。有三名患者减少了大约50%。所有患者都注意到了治疗效果，与二氧化碳激光治疗侧的结果相似。FPD激光治疗喉乳头状瘤的早期结果表明该方案是相对安全和可行的。长期结果尚待公布。由于FPD激光是凝固组织而不是蒸发组织，潜在的优势可能包括相对于CO2激光治疗减少疤痕，并提高患者和操作员的安全性。
To evaluate the feasibility and safety of the flash pump dye (FPD) laser for the treatment of laryngeal papillomas, we performed a prospective nonrandomized trial comparing FPD and carbon dioxide (CO2) laser treatment of laryngeal papillomas in a tertiary care children's hospital. Nine patients from 2 to 20 years of age with severe recurrent laryngeal papillomas were enrolled in the study. All patients underwent CO2 laser debulking of papillomas on the left hemilarynx, with 8 W continuous or pulsed energy. The right hemilarynx was treated with the FPD laser with 12 to 77 pulses at 8 to 12 J, through a custom-designed 90 degrees firing fiber. An end point of blanching and purpura of the papillomas was used. The main outcome measures were the safety and ease of operation with the FPD laser, and decreased papilloma size based on visual inspection at 2 weeks postoperative and at the next laser procedure. Seven patients were irradiated I time with an FPD laser, and 2 patients 2 times. No intraoperative complications were noted. One patient developed early postoperative strider. No patients described more discomfort, and 5 patients described their voice as being the same as or better than it was after prior CO2 laser procedures. Five patients had a 90% or more decrease in size of papillomas on the FPD-irradiated side 2 weeks postoperatively. Three patients had approximately a 50% reduction. A treatment effect was noted in all patients, and was similar to the results noted on the CO2 laser-treated side. Early results with FPD laser treatment of laryngeal papillomas suggest the protocol is relatively safe and feasible. Long-term results are pending. Because the FPD laser coagulates rather than vaporizing tissue, potential advantages may include decreased scarring relative to CO2 laser treatment, and improved patient and operator safety.