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成人咽喉部静脉畸形的内镜下钬激光间质治疗

Endoscopic Ho laser interstitial therapy for pharyngolaryngeal venous malformations in adults.

作者信息

Xiuwen Jiang, Jianguo Tang

机构信息

Department of Otolaryngology, Head and Neck Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, 310016, China.

出版信息

Eur Arch Otorhinolaryngol. 2015 Apr;272(4):937-940. doi: 10.1007/s00405-014-3463-y. Epub 2014 Dec 23.

Abstract

Many methods have been used to treat venous malformations, including sclerotherapy, laser therapy, and surgery. Nowadays, endoscopic laser surgery has become a popular therapeutic modality for most of pharyngolaryngeal venous malformations. There are various kinds of lasers that have been applied, but Holmium:YAG laser (Ho laser) has not been reported yet. Ho laser is produced by a kind of iraser which is made of yttrium aluminum garnet mixed with holmium, chromium and thulium. Aim of the current work is to evaluate the efficacy and safety of Ho laser interstitial therapy in pharyngolaryngeal venous malformations in adults. The clinical data of 42 patients with pharyngolaryngeal venous malformation treated with endoscopic Ho laser interstitial therapy over a 12-year period were retrospectively reviewed and analyzed. The wave length of Ho laser was 2.1 µm and the diameter of optical fiber was 550 µm. The pulse energy was 0.5 J and the time of duration was 600 µs. The highest output power was 100 W. Outcomes were graded as cure (complete resolution), considerable reduction (>60-80 % reduction), and no obvious change (<50 % reduction). The lesions were well controlled without severe complications. Complete resolution of the lesion was observed in 95.1 % of the patients, while 4.9 % patients showed considerable reduction of the swelling. Complications occurred in 4.8 % of patients. No respiratory troubles or other severe complications occurred. Endoscopic Ho laser interstitial therapy is an effective and safe treatment modality for pharyngolaryngeal venous malformations in adults.

摘要

治疗静脉畸形的方法有很多,包括硬化治疗、激光治疗和手术治疗。如今,内镜激光手术已成为大多数咽喉部静脉畸形的常用治疗方式。已应用的激光种类繁多,但钬激光(Ho激光)尚未见报道。Ho激光由一种掺钬、铬和铥的钇铝石榴石制成的激光器产生。本研究的目的是评估Ho激光间质治疗成人咽喉部静脉畸形的疗效和安全性。回顾性分析了12年间接受内镜下Ho激光间质治疗的42例咽喉部静脉畸形患者的临床资料。Ho激光波长为2.1μm,光纤直径为550μm。脉冲能量为0.5J,持续时间为600μs。最高输出功率为100W。结果分为治愈(完全消退)、显著缩小(缩小>60-80%)和无明显变化(缩小<50%)。病变得到良好控制,无严重并发症。95.1%的患者病变完全消退,4.9%的患者肿胀明显减轻。4.8%的患者出现并发症。未发生呼吸问题或其他严重并发症。内镜下Ho激光间质治疗是治疗成人咽喉部静脉畸形的一种有效、安全的治疗方式。

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