title: Use of the carbon dioxide laser for tracheobronchial lesions in children.
abstract: OBJECTIVE
  Obstructing tracheobronchial diseases in children can be treated by a variety of techniques. The nonfiberoptic delivery of the carbon dioxide laser coupled to a rigid bronchoscope has rarely been described for this purpose and has unique advantages over other treatment methods.
  
  
  OBJECTIVE
  To report the indications, safety, efficacy, and limitations of the carbon dioxide laser delivered through a rigid bronchoscope for tracheobronchial lesions in the pediatric population.
  
  
  METHODS
  Case series of patients undergoing treatment for tracheobronchial lesions at a single institution from December 2, 2001, through December 14, 2011.
  
  
  METHODS
  Tertiary care children's hospital.
  
  
  METHODS
  Seventeen patients aged 3 months to 17 years with endotracheal and endobronchial disease.
  
  
  METHODS
  Carbon dioxide laser treatment through a rigid bronchoscope.
  
  
  METHODS
  Reduction in tumor burden or improvement of ventilation.
  
  
  RESULTS
  A total of 234 laser bronchoscopies were performed on 17 patients. Mean operative time was 29 (range, 2-89) minutes. Blood loss and complications were minimal. Sixteen patients received carbon dioxide laser delivered through a rigid bronchoscope with a proximal coupler or flexible fiber. The most common indication was tracheobronchial granulation tissue (n = 10), followed by prolapsed cartilage causing tracheal obstruction (n = 3), recurrent respiratory papillomatosis (n = 2), and granular cell tumor (n = 1). Of these patients, 15 (94%) underwent successful treatment. One patient was treated electively with the Nd:YAG laser owing to a vascular malformation.
  
  
  CONCLUSIONS
  The carbon dioxide laser delivered through a rigid bronchoscope is a suitable tool for managing nonvascular endotracheal and endobronchial lesions in the pediatric population. Its unique wavelength properties offer a safe, effective alternative to other lasers and open resection.
authors: Department of Otolaryngology, University of Minnesota Medical School, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA.
authors: Phayvanh P
authors: PP
authors: Sjogren
authors: James D
authors: JD
authors: Sidman
mesh_terms: D000293:Adolescent; D001982:Bronchial Diseases / Q000601:surgery*; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D054020:Lasers, Gas; D008297:Male; D014133:Tracheal Diseases / Q000601:surgery*; D016896:Treatment Outcome