Subglottic hemangioma: a comparison of CO2 laser, Neodym-Yag laser, and tracheostomy.

摘要: For airway obstruction caused by subglottic hemangiomas, tracheostomy is still regarded some as the only established therapy, despite numerous other therapeutic options. Resection with lasers was also reported, but scar formation may occur, and different laser types have advantages over others. The charts of 46 consecutive patients 26 years were reviewed. Until 1986, therapy involved systemic steroids or tracheostomy. Thereafter, a Neodym-Yag after 1995 CO2 used. Mean initial stenosis 61.0% in first (n=15), 85.8% (n=14), 86.7% period (n=17). Tracheostomy rates could be reduced from 76.9% to 46.9% 30.8% laser, 22.2% children not intubated before referral. One resulted severe neurological damage; granulomas required resection 37.5%. Secondary found 15.4% Neodym-Yag, laser. With tracheostomy, 12.5% symptom-free at age 2-3 years, vs. 25.0% 41.6% period. Speech development delayed 75.0% parental anxiety lessened 18.8% second birthday (68.8% without tracheostomy). Since end retrospective analysis, we treated further 21 (mean stenosis, 83.3%) one (4.8%). Compared significant reduction morbidity speech developmental delay, an improved quality life, achieved resection, this approach superior