Clinical applications of the holmium : YAG laser in disorders of the paediatric airway

Objective: The aim of this study was to review the role of the holmium:YAG laser in the management of paediatric airway disorders. Method: Twenty-six paediatric patients underwent 42 airway procedures betwe en June 1993 and August 1996 in a tertiary care centre. A case series desig n was used. Outcome Measures: Safety, precision, hemostasis, bone-cutting properties, a nd accessibility of the lesion to the equipment were compared to standard t herapies. Postoperative outcomes were then compared to standard therapies. Results: Eight patients underwent correction of choanal atresia or revision , 10 patients underwent functional endoscopic sinus surgery, 3 underwent ex cision of tracheal granuloma, 2 underwent excision of tracheal web or revis ions, 1 underwent excision of subglottic stenosis and bronchial stenosis, 1 underwent excision hemangioma of the tongue, and 1 underwent excision papi lloma of the oral cavity. One patient in 42 procedures suffered a surgical complication. Our early success rates are comparable to other series using the carbon dioxide laser or cold instruments. Conclusion: The holmium:YAG laser is a safe, effective tool in the treatmen t of paediatric airway disorders and offers the advantage of a flexible fib re-optic system, good hemostasis, and better bone-cutting characteristics c ompared to the carbon dioxide laser, which is in widespread clinical use.