Late lethal secondary hemorrhage after laser supraglottic laryngectomy.
Since 1971, a number of articles have been published regarding the complications encountered with laser surgery of the larynx. Most investigations focus on complications such as accidental burns caused by the reflection of the laser beam, endotracheal explosion, special anesthesiologic problems, edema of the mucosa leading to airway obstruction, and abnormal scar formation with functional problems. Secondary hemorrhage has played a subordinate role, and in the few articles that have focused on it, cases requiring postoperative treatment have been reported only sporadically. All of these cases occurred within the first postoperative week, and no case resulting in the death of a patient was reported. We describe a patient in whom a lethal secondary hemorrhage occurred 10 days after a laser supraglottic laryngectomy. Because of the increase of laser applications in the treatment of laryngeal carcinoma, similar complications may be encountered. We comment on possible pathophysiological mechanisms and consequences.
Kremer
B
B
Department of Otorhinolaryngology, Head and Neck Surgery, University of Maastricht, P Debyelaan 25, PO Box 5800, NL-6202 AZ Maastricht, The Netherlands. B.Kremer@kno.azm.nl
Schlöndorff
G
G
D002294:Carcinoma, Squamous Cell; D004825:Epiglottis; D017809:Fatal Outcome; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D053685:Laser Therapy / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000209:etiology*