Laser Supraglottoplasty

Laryngomalacia is the most common laryngeal anomaly affecting newborns. Patient’s with severe disease should be considered for supraglottoplasty. It classically presents in a newborn with high-pitched inspiratory stridor that worsens with exertion, supine-positioning, and feeding. It is characterized by anatomic and physiologic abnormalities including shortened aryepiglottic (AE) folds, small, tightly curled epiglottis, redundant soft tissue overlying the cuneiform or accessory cartilages and reduced laryngeal tone. Any combination of these may present with laryngomalacia. Most cases are mild and resolve with observation or medical therapy.

Steps:
1. Laser precautions are taken to protect patient and personnel.
2. Spontaneous ventilation
3. Suspension laryngoscopy is performed with adequate visualization of the larynx.
4. The operating telescope or microscope is used for visualization. The CO2 laser is tested.
5. First, division of the AE folds is performed.
6. Next, redundant mucosa and tissue overlying the accessory cartilages is ablated.

Endoscopic Removal of Suprastomal Granuloma Using a Flexible KTP laser

Surgical removal of suprastomal granuloma is a procedure performed prior to the probable decannulation of a tracheostomy. There are several ways of achieving this objective, but in certain cases, a KTP laser on a flexible delivery system offers a precise and controlled method to successful debulking of the granuloma with minimal risks of haemorrhage into the airway.

DOI: http://dx.doi.org/10.17797/pqzu0ns9y9

Editor Recruited By: Sanjay Parikh, MD, FACS

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