A retrospective analysis of CO2 laser and microdebrider for the treatment of severe juvenile on-set recurrent respiratory papillomatosis
10.3760/cma.j.issn.1673-0860.2017.10.004
- VernacularTitle: CO2激光结合显微电动吸切器治疗重症幼年型复发性呼吸道乳头状瘤回顾性分析
- Author:
Qingwen YANG
1
;
Wen XU
1
;
Wei GUO
1
;
Weixin CUI
1
;
Yanru LI
1
;
Xiaoyi WANG
1
;
Jing YANG
1
;
Xueyan LI
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery(Capital Medical University), Ministry of Education of China, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
Papilloma;
Laryngeal diseases;
Lasers, gas;
Microdebrider
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2017;52(10):733-737
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Juvenile on-set recurrent respiratory papillomatosis (JORRP) can be an aggressive and potentially life-threatening disease. To emphasize the importance of complication prevention in local excision surgery, the single-center experience of RRP treatment in a group of patients with relatively short recurrence-free-interval (>4 times/yrs) was reported.
Methods:Data of 49 patients underwent papilloma resection during 2002-2013 were retrospectively analyzed. Combined techniques of laser microsurgery and microdebriders were used to remove papillomas, prevent the formation of scar tissue and improve respiratory distress. Forty-nine cases were followed up for 99.0[74.5; 121.0]months, ranging from 39 to 185 months. The age of disease onset was 2[1; 3] years old. Most of the patients had difficulty in breathing(42 of 49 cases). Seven patients had hoarseness.53.0% patients had subglottic or trachea papillomatosis spreading. The rate of complications, synechia formation, tracheal stenosis, needing for tracheostomy, mortality was recorded. Patients were followed up for at least three years. The characteristics of the patients, improvement in symptoms, recurrence-free interval, and the rate of tracheal extubation were evaluated. Wilcoxon signed ranks test and chi-square test were used for data comparation.
Results:Long-term relieve in disease(≤2 surgeries were needed/year) were achieved in 29(59.1%) subjects, in which 8(16.3%) of the subjects did not need surgical treatment for at least 3 years. Long-term relieve had been achieved in 25 of subjects who did not accept tracheostomy. Seven subjects did not need surgical treatment for at least 3 years. The rate of successful tracheal extubation was 53.8% in 13 patients who had undergone tracheostomy. Three cases dead of intrapulmonary spread.
Conclusions:Combined techniques of laser microsurgery and microdebriders are effective in improvement in both respiratory distress and voice quality. The combined technique are helpful to avoid inevitable long-term stenotic complications, ultimately affecting the quality of life.
