Objective: To investigate the clinical effects of ultra-pulsed fractional carbon dioxide laser (UFCL) in the treatment of mild to moderate microstomia after burns. Methods: A retrospective observational study was conducted on 19 patients with mild to moderate microstomia after burns who were admitted to Inner Mongolia Baogang Hospital from January 2018 to January 2022, including 15 males and 4 females aged (35±14) years. Patients had an average course of 71 d of microstomia, with 8 cases of moderate microstomia and 11 cases of mild microstomia. All the patients received UFCL treatment every 2-3 months until the microstomia was corrected or the treatment bottleneck was reached. The times of UFCL treatment for patients and the time interval from the last treatment to the last follow-up were recorded. Before the first treatment and at the last follow-up, the opening degree of mouth (finger measurement method), oral gap width, and the distance between the upper and lower incisors during mouth opening were recorded. Before the first treatment and at the last treatment, the new Vancouver scar scale (VSS) was used to evaluate the scar. At the last follow-up, the degree of satisfaction was evaluated by the Likert 5 scale by the patients themselves, and the satisfaction ratio was calculated; the adverse reactions such as pigmentation, blisters, infection, and persistent erythema in the treatment area were counted. Data were statistically analyzed with Mann-Whitney rank sum test or paired sample t test. Results: Patients received UFCL treatment of 3 (2, 6) times. The interval from the last treatment to the last follow-up was 26 months at most and 4 months at least. At the last follow-up, the opening degree of mouth of patients was significantly improved than that before treatment (Z=4.68, P<0.01). At the last follow-up, the oral gap width of patients was (35±6) mm, and the distance between upper and lower incisors during mouth opening was (3.2±0.4) cm, which was significantly improved compared with those before treatment (with t values of 10.73 and 18.97, respectively, P<0.01). The VSS score after the last treatment was 4.1±1.6, which was significantly better than that before treatment (t=22.96, P<0.01). At the last follow-up, the satisfaction ratio of patients with treatment was 18/19, and no pigmentation, blisters, infection, persistent erythema, and other adverse reactions of all patients in the treatment area occurred, however, one of the patients reported that the disease recurred about half a year after treatment. Conclusions: UFCL is an effective method for treating mild to moderate microstomia after burns, with which patients are highly satisfied, and it is worth of further study and promotion.
Blister ; Burns/therapy* ; Cicatrix/therapy* ; Female ; Humans ; Lasers, Gas/therapeutic use* ; Male ; Microstomia ; Treatment Outcome

OBJECTIVETo evaluate the feasibility and safety of CO2 laser supraglottoplasty for severe laryngomalacia in infants.

METHODSFrom January 2009 to December 2011, 32 infants with severe laryngomalacia were confirmed by electronic laryngoscope and clinical assessment in Shenzhen Children's Hospital. According to the choice made by the parents, 16 children accepted CO2 laser supraglottoplasty (group 1), the others were treated conservatively (group 2). The beginning observation point T0 was defined as the age on the first medicine taking day or the age of surgery. T1, T3, T6 were defined as 1, 3, 6 months following T0. Clinical symptoms included stridor, dyspnea, aspiration, and respiratory infections. The body weight, PSG reports, laryngoscope findings, cure rates of the two groups were compared.

RESULTSThe anatomical abnormalities were corrected surgically, and the symptoms ,such as stridor, dyspnea, and aspiration improved rapidly after the operation. The cure rates was higher in group 1 than in group 2 on T1, T3, T6 stage. There were statistically significant differences(χ(2) were 13.9, 28.1, 24.6 respectively; all P < 0.01). Children in group 1 gained weight better than in group 2. There was a statistically significant difference in Z scores median on T1, T3, T6 stage (z score were -0.848, -2.940, -4.110; P < 0.05, or P < 0.01 respectively). The lowest oxygen saturation in group 1 improved one month after the surgery (from average 0.686 ± 0.106 to 0.901 ± 0.041). There was a statistically significant difference (t = -7.876, P = 0.001). Complications included adhesion (1 case) and temporary new-onset aspiration (1 case).

CONCLUSIONSThe CO2 laser supraglottoplasty can resolve severe laryngomalacia symptoms including stridor, dyspnea and aspiration. It can reduce the frequency of respiratory infections, and contribute to weight gaining. The CO2 laser supraglottoplasty is effective, of high security and with rare complications.

Carbon Dioxide ; Glottis ; Humans ; Infant ; Infant, Newborn ; Laryngomalacia ; radiotherapy ; Laryngoscopes ; Lasers, Gas ; therapeutic use ; Low-Level Light Therapy ; Retrospective Studies

Objective: To compare the efficacy, advantages and disadvantages of endoscopic CO₂ laser cauterization (ECLC) and open neck surgery in the treatment of congenital pyriform sinus fistula (CPSF). Methods: From September 2014 to March 2017, 80 cases with confirmed diagnosis of CPSF received initial treatment at Guangdong Provincial People's Hospital were prospectively analyzed, including 34 males and 46 females, aged 18 to 672 (194.17±141.18) months. They were consecutively divided into endoscopic group and open-surgery group, with 40 cases in each group. Both groups of patients received surgical treatment under general anesthesia. The endoscopic group was treated by endoscopic CO₂ laser cauterization, and the open-surgery group underwent the following surgery: first, we performed suspension laryngoscopy examination to confirm the presence of fistula in the bottom of the piriform fossa, then open-neck resection of congenital piriform sinus fistula with recurrent laryngeal nerve and/or lateral branch of superior laryngeal nerve anatomy plus partial thyroidectomy were performed. The data between the two groups were compared, including the operative time, intraoperative blood loss, postoperative pain, average length of stay, neck cosmetic scores, complications and cure rates. All patients were followed up in outpatient clinics. Statistical analysis was performed using SPSS 20.0 software. P<0.05 indicates that the difference is statistically significant. Results: All patients were successfully completed the operation. The operative time, intraoperative blood loss, postoperative pain and average length of hospital stay in the endoscopic group were significantly less than those in the open group [(27.4±5.5) min to (105.8±52.5) min, (0.6±0.5) ml to (33.6±41.5) ml, (1.7±0.9) points to (4.6±0.7) points, (5.9±2.9)d to(8.9±3.3)d, t values were-9.400, -5.031, -16.199, -4.293, P values were all<0.01]; The neck cosmetic score in the endoscopy group was significantly greater than that of the open group [(9.9±0.4) against (5.8±0.9) points, t=25.847, P<0.01]. Compared with the open group (15.0%, 6/40), the complication rate of the endoscopic group (7.5%, 3/40) was not statistically significant (χ²=0.50, P>0.05). Three months after the first treatment, the cure rate in the endoscopic group (82.5%, 33/40) was significantly lower than that in the open-neck group (100.0%, 40/40), χ²=5.64, P<0.05. The follow-up time was 12 months after the last treatment. Eighty cases were followed up and none was lost to follow-up. During the follow-up period, the cure rate of the endoscopy group (97.5%, 39/40) was compared with that of the open group (100.0%, 40/40), and the difference was not statistically significant. Conclusions: In the treatment of CPSF, the two-surgical method each has their advantages. Compared with open-neck surgery, ECLC is simpler, repeatable. ECLC has shorter time in operation and hospital stay, less complications, and less postoperative pain and more precise cosmetic results. It could be preferred for the initial treatment of CPSF and relapsed cases after cauterization. But subject to relatively low cure rate of one-time cauterization and uncertain long-term efficacy, it cannot completely replace the open-neck surgery at present.
Carbon Dioxide ; Cautery ; Endoscopy ; Female ; Fistula/surgery* ; Humans ; Lasers, Gas/therapeutic use* ; Male ; Pyriform Sinus/surgery* ; Retrospective Studies ; Treatment Outcome

Objective: To explore the clinical effects of fractional carbon dioxide laser combined with minimally invasive scar release in the treatment of post-acne atrophic scars. Methods: A retrospectively observational study was conducted. From January to June 2021, 60 patients with grade 3 and 4 post-acne atrophic scars who met the inclusion criteria were admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine. According to the adopted treatment methods, 30 patients treated with fractional carbon dioxide laser combined with minimally invasive scar release were included in combined treatment group (19 males and 11 females, aged (26±4) years), and 30 patients treated with fractional carbon dioxide laser alone were included in laser alone group (18 males and 12 females, aged (25±6) years). All the patients received the treatment once every two months, totally 3 times. Before the first treatment and 2 months after the last treatment, the scars were assessed by échelle d'évaluation clinique des cicatrices d'acné (ECCA). In 2 months after the last treatment, the curative effect was evaluated and the total effective rate was calculated according to the ECCA score. The adverse reactions of patients during the treatment were recorded. Data were statistically analyzed with independent sample t test, Wilcoxon rank-sum test, Mann-Whitney U test, chi-square test, and Fisher's exact probability test. Results: Before the first treatment, the ECCA scores of patients in the two groups were similar (P>0.05). In 2 months after the last treatment, the ECCA scores of patients in combined treatment group were significantly lower than those of laser alone group (Z=-2.89, P<0.05). The ECCA scores of patients in combined treatment group and laser alone group in 2 months after the last treatment were both significantly lower than those before the first treatment (with Z values of -4.81 and -4.79, respectively, P<0.05). In 2 months after the last treatment, the treatment in laser alone group cured the scars in 2 patients, and were markedly effective in 13 patients, effective in 7 patients, and ineffective in 8 patients; the treatment in combined treatment group cured the scars in 4 patients, and were markedly effective in 22 patients, effective in 3 patients, and ineffective in one patients. The total effective rate of scar treatment in combined treatment group (96.67%, 29/30) was significantly higher than 73.33% (22/30) in laser alone group (P<0.05). During treatment, in combined treatment group, 3 patients had pain, one patient had redness and swelling, and one patient had pigmentation. In laser alone group, one patient had pain, and 2 patients had pigmentation. No infection occurred in the wounds of all the patients in the two groups. Conclusions: Compared with fractional carbon dioxide laser alone, fractional carbon dioxide laser combined with minimally invasive scar release for post-acne atrophic scars can result in a higher total effective rate, with simple operation and good effect, so it is worthy of clinical application.
Male ; Female ; Humans ; Cicatrix/therapy* ; Retrospective Studies ; Treatment Outcome ; Lasers, Gas/therapeutic use* ; Acne Vulgaris ; Atrophy ; Pain ; Carbon Dioxide

OBJECTIVE: To define the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carci noma. METHOD: A retrospective study of 112 patients with laryngocarcinoma treated. Surgical treatment included endoscopic CO2 laser cordectomies according to the classification of the European Laryngological Society. After the patients were given the general anesthesia and oral intubation, the tumors in the study group were resected along the margin of the tumor under larynscope, and the safety margin was reserved as 3-5 mm. All the patients were followed-up for 12-62 months. RESULT: Eight relapses were detected in 112 cases of glottic laryngeal carcinoma after CO2 laser surgery. The local recurernce rate was 7.14% (8/112),of the rate for T1a, T1b and T2 were 0.89%, 0.89% and 5.04% respectively, with significant differences among groups (chi2 = 5.306, P < 0.01) . The rate of local recurrence rate of anterior commissure involvement was 7.14% and that was 7.14% when this site was not compromised by the tumor, which has no statistically significant differences (chi2 = 0.000, P > 0.01). CONCLUSION According to our reaserch, endoscopic CO2 laser sur gery is an effective treatment for early laryngocarcinoma.
Adult ; Aged ; Aged, 80 and over ; Carbon Dioxide ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; surgery ; Laser Therapy ; Lasers, Gas ; therapeutic use ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVE: To review our experience with the use of the CO2 laser combined with pingyangmycin in the treatment of pharyngeal and laryngeal hemangioma. METHOD: A retrospective review of 18 patients with pharyngeal and laryngeal hemangioma treated with CO2 laser combined with pingyangmycin was carried out in our hospital: patients medical charts were evaluated for factors such as age, sex, location of hemangioma, number of laser procedures performed, and postoperative results, including short and long term complications. RESULT: All the 18 patients were underwent operation without any complications such as pharyngeal and laryngeal hemorrhage, infection of incisional wound,laryngeal edema, etc. Data of follow-up for 7 months to 5 years, showed that excellent local control was achieved in all cases with the exception of one case of recurrence. The one case recurred 4 months after operation and treated with CO2 laser again. CONCLUSION With careful selection of patients, the CO2 laser combined with pingyangmycin pingyangmycin is a safe and effective treatment for pharyngeal and laryngeal hemangioma with the following advantages: precise location for treating, less bleeding, clear operating field, simple management, low risk of infection, less post-operation reaction, protection of laryngeal and pharyngeal structures and avoidance of tracheostomy.
Adult ; Bleomycin ; analogs & derivatives ; therapeutic use ; Combined Modality Therapy ; Female ; Hemangioma ; therapy ; Humans ; Hypopharynx ; Larynx ; Lasers, Gas ; therapeutic use ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE: To summarize clinical experience of application of argon knife under electronic bronchoscope in the management of pediatric glottic and subglottic diseases. METHOD: Reports in the literature were reviewed. Outcome and prognosis of 4 cases with pediatric glottic and subglottic diseases managed with argon beam coagulator technique in Shanghai children's Medical Center since 2011 were retrospectively analyzed. RESULT: Granulation tissue hyperplasia in 3 cases with subglottic lesions did not recur after surgery. Scarring or stenosis were not found in the airway. Intubation of the trachea and tube of tracheotomy was pulled out successfully in all cases, restoring normal breathing. No lesion recurrence was found in 1 case with squamous cell moderate atypical hyperplasia one month after the surgery. CONCLUSION Electronic bronchoscope has advantages of clear image, fine and soft lens body, optional bending, angle conversion, accurate positioning. And the argon knife with small head diameter can pass the pediatric supraglottic. It can be manipulated precisely with short operation time and no damage to surrounding normal tissues. Its worth in popularization and application of management for with glottic and subglottie disease in pediatric patients.
Adolescent ; Argon ; therapeutic use ; Bronchoscopes ; Child ; China ; Cicatrix ; Humans ; Hyperplasia ; Intubation, Intratracheal ; methods ; Laryngeal Diseases ; surgery ; Lasers, Gas ; therapeutic use ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Tracheotomy ; instrumentation

OBJECTIVETo investigate the efficacy of CO2 laser combined with 32P-patch contact brachyradiotherapy for the treatment of keloids.

METHODSFrom 2001 to 2006, 121 cases with 151 keloids, which reoccurred after treatment with more than 2 methods, underwent continuous CO2 laser treatment to remove the hypertrophic scar tissue, following by ultra-pulse CO2 laser to treat the fresh granulation tissue. After wound healing, 32P-patch contact brachyradiotherapy was used for the lesion, 0.5-1 MBQ/cm2 for 72-96 hours, every 1-2 months. 2-3 treatment were applied.

RESULTSAmong the 151 keloids, good result was achieved in 111 keloids, and effective result in 40 keloids. Adverse effect included hyperpigmentation in 21 lesions and hypopigmentation in 32 lesions. The patients were followed up for 2-6 years without relapse.

CONCLUSIONCO2 laser combined with 32P-patch contact brachyradiotherapy is an effective and safe method for the treatment of recalcitrant keloids.

Adolescent ; Adult ; Female ; Humans ; Keloid ; therapy ; Lasers, Gas ; therapeutic use ; Male ; Middle Aged ; Phosphates ; administration & dosage ; therapeutic use ; Phosphorus Radioisotopes ; administration & dosage ; therapeutic use ; Transdermal Patch ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the feasibility and curative effects of transoral CO2 laser in treatment of hypopharyngeal carcinoma.

METHODSThe retrospective analysis included 24 cases of hypopharyngeal carcinoma from 1994 to 2005 in the Department of Head and Neck. All cases were treated with endoscopic laser surgery and adjuvant selective neck dissection or radiotherapy. The follow-up period was more than 3 years. Twenty-four patients (21 male, 3 female) were classified as follows: 14 cases were T1N0M0, 4 were T1N1M0, 1 was T1N2bM0, 3 were T2N0M0 and 2 were T2N2bM0.

RESULTSKaplan-Meier survival analysis showed the overall 5-year survival rate was 74.9%, and the 5-year survival rate of T1 lesions and T2 lesions was 78.8% and 60.1%, respectively. The overall 5-year local control rate was 82.1% and 5-year larynx preservation rate was 87.0%. Six of 7 patients with local-regional recurrences underwent salvage surgery and radiotherapy. Finally 4 of them died of recurrence again and 2 were survival. The other one of 7 patients had distant metastasis, and died after radiochemotherapy. One patient died of non-neoplastic diseases. Two patients experienced minor complications with conventional ambulatory treatment without sequelae. All survival patients had laryngeal preservation except the one who received salvage surgery of the hypopharynx and larynx.

CONCLUSIONSEndoscopic CO2 laser surgery with adjuvant selective or modified radical neck dissection and radiotherapy is an alternative for the treatment of selected hypopharyngeal carcinoma, associated with satisfying curative effects and a high larynx preservation rate.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; surgery ; Female ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Laser Therapy ; Lasers, Gas ; therapeutic use ; Male ; Middle Aged ; Neck Dissection ; Retrospective Studies

OBJECTIVETo explore the clinical effects of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine ( Fuchunsan ) on the treatment of postburn hyperplastic scar.

METHODSSixty-three patients with hyperplastic scar after burn injury hospitalized from February 2012 to June 2014 in our department were treated with lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan). Patients were divided into early stage group (E, n = 35), middle stage group (M, n = 25), and late stage group ( L, n = 3) according to the formation time of scar, which was respectively 3 weeks to 3 months, longer than 3 months and less than or equal to 6 months, and 3 to 15 years in groups E, M, and L. The number of times of laser treatment of patients in each group was recorded. The degree of scar pain in patients of the three groups was assessed by the Numerical Rating Scale (NRS) before treatment and after treatment for 1, 2, and 3 times. The scar condition of patients in groups E and M was assessed by the Vancouver Scar Scale (VSS) before treatment and after treatment for 1, 3, and 5 times. Patients in group L did not receive VSS assessment but were evaluated by clinical observation only. Photos of scar in treating area were taken before treatment and after treatment for 3 and 5 times to evaluate the clinical effect. Data were processed with t test.

RESULTSPatients in groups E and M were treated with laser for (4.8 ± 1.1) and (7.7 ± 2.1) times respectively. In group L, the treatment was stopped in 2 patients after laser treatment for 5 times, and 1 patient received laser treatment for 12 times. The degree of pain in patients of groups E and M was alleviated significantly after treatment for one time, and the number of patients scoring 1-4 point(s) in NRS increased from 5 cases to 38 cases. After treatment for 2 and 3 times, the increase in the number of patients scoring 1-4 point (s) in NRS was on a small scale. Before treatment and after treatment for 1 time, VSS scores of patients in groups E and M were similar (with values respectively 0.641 and 0. 082, P values above 0. 05). After treatment for 3 and 5 times, VSS scores of patients in group E were respectively (9.2 ± 0.8) and (7.0 ± 1.1) points, which were significantly lower than those in group M [ (9.7 ± 1.0) and (8.2 ± 1.0) points, with values respectively -1.993 and -4.433 , P < 0.05 or P < 0.01]. After treatment for 3 times, the rate of improvement in appearance was respectively 88.6% (31/35) and 72.0% (18/25) in groups E and M, and it was respectively 100.0% (35/35) and 96.0% (24/25) after treatment for 5 times. No significant effect in appearance was found in the 3 patients in group L.

CONCLUSIONSEarly application of lattice ultra pulse carbon dioxide laser combined with traditional Chinese medicine (Fuchunsan) for the treatment of postburn hyperplastic scar is effective.

Burns ; Cicatrix ; etiology ; prevention & control ; Humans ; Lasers, Gas ; therapeutic use ; Medicine, Chinese Traditional ; Postoperative Care ; methods ; Postoperative Complications ; prevention & control ; Treatment Outcome