title: LASER Treatment of Laryngeal Papillomatosis in a Young Child: Anaesthetic and Surgical Management.
abstract: The authors report the case of a 4-year boy who required anaesthetic and surgical care during LASER excision of laryngeal papillomatosis. He presented with hoarseness and stridor and underwent emergency tracheostomy after confirmation of laryngeal papillomas on CT scan. He required LASER treatment under general anaesthesia with a requirement of paediatric LASER-safe endotracheal tube but unfortunately, this was not available in the country. Balanced anaesthesia technique using inhalational anaesthetic, muscle relaxant and narcotic is used with modifications. After three successful surgical sessions, the airway became patent and tracheostomy was de-cannulated. The perioperative issues surrounding this process are discussed including anaesthetic induction in the patient with a compromised airway, maintenance anaesthetic techniques, methods used for ventilation during LASER surgery of the upper airway, surgical implications and hazards of LASER to the operating room personnel.
authors.affiliation: Department of Anaesthesiology, The Aga Khan University, Stadium Road, Karachi.
authors.forename: Faisal
authors.initials: F
authors.lastname: Shamim
authors.affiliation: Department of Anaesthesiology, The Aga Khan University, Stadium Road, Karachi.
authors.forename: Durriya
authors.initials: D
authors.lastname: Raza
authors.affiliation: Department of Surgery, The Aga Khan University, Stadium Road, Karachi.
authors.forename: Mubasher
authors.initials: M
authors.lastname: Ikram
mesh_terms: D000402:Airway Obstruction / Q000150:complications* / Q000601:surgery; D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D000777:Anesthetics / Q000008:administration & dosage; D002648:Child; D006801:Humans; D007442:Intubation, Intratracheal; D007822:Laryngeal Neoplasms / Q000601:surgery*; D053685:Laser Therapy; D008297:Male; D010212:Papilloma / Q000601:surgery*; D014139:Tracheostomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000777:Anesthetics