USE OF THE CO2-LASER MICROPOINT MICROMANIPULATOR FOR THE TREATMENT OFLARYNGOMALACIA

Between September 1989 and June 1994, 21 children (17 boys, 4 girls) w ith moderate to severe symptoms due to laryngomalacia underwent endosc opic surgery using the CO2-laser micropoint manipulator (shot-by-shot, 0.1 s, super-pulse, 2-3 W power; 280 mu m beam; 400 mm working distan ce). Mean age of the children was 5 months (range, 1-11 months), The p rocedure was performed under high-frequency jet ventilation and consis ted in the resection and/or vaporization of the aryepiglottic folds, T his tissue removal could be extended to the laryngeal mucosa of the ar ytenoids and the lateral edge of the epiglottis. Results of surgery we re excellent with normalization (8 patients) or, at worst, a very defi nite improvement of symptoms (4 patients). Furthermore, no complicatio ns occurred due to the technique used. These results have convinced us that the CO2-laser micropoint manipulator technique, with the ''super -pulse'' shooting mode and high-frequency jet ventilation, is by far s uperior to microsurgery with cold instruments when endoscopic treatmen t of laryngomalacia is indicated.