FATAL GAS EMBOLISM AS A COMPLICATION OF ND-YAG LASER-SURGERY DURING TREATMENT OF BILATERAL CHOANAL STENOSIS

A 40-day-old infant boy underwent Nd-YAG laser surgery because of cong enital bilateral choanal stenosis. Cyanosis and cardiovascular collaps e occurred during the operation. Resuscitation was initiated, but in v ain; the patient died. The evolution of clinical events was consistent with a diagnosis of gas embolism. In the investigation of causes, the use of a sapphire tip with the Nd-YAG laser and the cooling of the ti p with N2 gas were thought to have contributed to the fatal outcome. T he authors warn of the potential risk of gas embolism with the Nd-YAG laser and a coaxial gas cooling system, and they emphasize the importa nce of monitoring for gas embolism in high-risk patients.