Feasibility of transnasal flexible carbon dioxide laser surgery for laryngopharyngeal lesions

The fiber-guided carbon dioxide (CO2) laser is a useful device for laryngopharyngeal surgery. The flexible CO2 wave-guide laser has been developed and commercially available for several years. However, the transnasal use of CO2 flexible wave-guided laser surgery through the instrument channel of a f...

Full description

Saved in:
Bibliographic Details
Published in:Auris, nasus, larynx nasus, larynx, 2019-10, Vol.46 (5), p.772-778
Main Authors: Araki, Koji, Tomifuji, Masayuki, Uno, Kosuke, Suzuki, Hiroshi, Tanaka, Yuya, Tanaka, Shingo, Kimura, Eiko, Shiotani, Akihiro
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Ambulatory Surgical Procedures
Anesthesia, Local
Carcinoma in Situ - surgery
Cysts - surgery
Epiglottis - surgery
Feasibility Studies
Female
Fiber guided CO2laser
Humans
In office surgery
Laryngeal Diseases - surgery
Laryngeal Neoplasms - surgery
Larynx
Laser Therapy - methods
Lasers, Gas - therapeutic use
Leukoplakia - surgery
Male
Middle Aged
Nasal Cavity
Natural Orifice Endoscopic Surgery
Otorhinolaryngologic Surgical Procedures - methods
Papillomavirus Infections - surgery
Pharyngeal Diseases - surgery
Pharyngeal Neoplasms - surgery
Pharynx
Recurrent respiratory papilloma
Respiratory Tract Infections - surgery
Transnasal flexible CO2 wave-guide laser surgery
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The fiber-guided carbon dioxide (CO2) laser is a useful device for laryngopharyngeal surgery. The flexible CO2 wave-guide laser has been developed and commercially available for several years. However, the transnasal use of CO2 flexible wave-guided laser surgery through the instrument channel of a flexible endoscope (CO2 TNFLS) is not permitted in Japan. This feasibility study aimed to assess the value and the safety of an in-office CO2 TNFLS procedure. Patients with small laryngopharyngeal diseases were enrolled from June 2015. Eligible patients had indications with lesions generally localized superficial lesions such as the benign tumor, leukoplakia, and premalignant lesion-like carcinoma in situ (CIS). Patients were locally well anesthetized using xylocaine. After removing as much of the lesion(s) as possible with flexible forceps, the remainder of the lesions were evaporated using CO2 TNFLS through the instrument channel of a flexible endoscope under local anesthesia. Eighteen surgeries involving 13 patients, including 9 papilloma (7 recurrent respiratory papilloma [RRP]), 2 carcinoma in situ, 1 leukoplakia, and 1 large epiglottic cyst), were performed. Four patients with RRP required multiple surgeries. Except for 3 patients with RRP, all patients achieved disease control without additional intervention. All procedures were completed with no severe adverse events. Office-based CO2 TNFLS is safe and feasible for patients with laryngopharyngeal pathologies. It is especially valuable for RRP patients with small lesions to avoid surgery under general anesthesia.
ISSN:0385-8146
1879-1476
DOI:10.1016/j.anl.2019.01.008