Сongenital tracheal stenosis in children treated with a laser technique

Abstract

Purpose. Three children with congenital stenosis of the upper trachea were treated with neodymium laser light via endoscopic approach. The technique was developed in the First City Clinical Hospital at the Pediatric Surgical Center (Minsk, Belarus) for treating congenital abnomalies of the upper respiratory tract in children. Material and methods. X-ray and tracheobronchoscopy with Olimpus MAF TYPE GM apparatus were used for examination under general anesthesia. Tracheal stenosis was treated with Multiline medical multifunctional laser complex (Linline Medical Systems LLC, Belarus) equipped with a high-level neodymium laser emitter. Vaporization was done with the fiber having a spherical diffuser and an emitter with wavelength 1340 nm and power 15 W; exposure – for 2 seconds. In cicatricial stenosis, the trachea was notched with laser scalpel having wavelength 1064 nm and power 20 W. Results. All three children with congenital tracheal stenosis prior to laser treatment had tracheostomy at the age between 3 and 8 months. In one child, laser technique was used for treating complications after reconstructive surgery on the trachea and esophagus. The performed treatment resulted in successful decanulation. In two children, endoscopic ablation and vaporization of soft tissues – instead of surgery- were repeatedly made. After that, in one child of these two a successful decanulation was made. Conclusion. Tracheostomy performed in children of very young age promotes the formation of tracheal stenosis what can cause later problems with decanulation. Neodymium laser light with endoscopic access can be successfully used to treat congenital tracheal stenosis.