Zhou C Y, Han J H, Sun B C, Chen M M, Dai Z Y, Shen Y, Wang F, Han Z L, Yang S Z, Wang T, Yang Q H
Department of Otolaryngology, the First Affiliated Hospital of PLA General Hospital, Beijing.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Dec;30(24):1918-1920. doi: 10.13201/j.issn.1001-1781.2016.24.003.
To observe the therapeutic effect of photodynamic therapy(PDT) on the treatment of juvenile onset laryngeal papillomatosis. Twenty-eight cases of children with laryngeal papilloma were treated,only 2 cases for the first time, and the rest were repeatedly treated outside our hospital, the average hospital surgery were more than 4 times. Under self retaining laryngoscope and microscope and endoscope assisted by semiconductor laser and plasma and cold instrument method，visible tumor resection and local affixed deposited 20% 5-aminolevulinic acid(photosensitizer) 3 hours later, with 635 nm semiconductor laser photodynamic,200-280 mW and can volume density of 80 to 120 J/cm², 20 min irradiation. PDT should be repeated after 25 days until no visible tumor.Then,2 times PDT must be done. In 28 cases, 24 cases were followed up for more than 1 years(12 cases were followed up for 3 years),19 had no recurrence, the cure rate was 79.2%(19/24)；5 cases recurrence, and the recurrence rate was 20.8%(5/24)，among them,2 cases were abandoned because of the relapse，the other 3 cases were cure after 3 times of PDT.The main complications were adhesion of larynx. The preliminary effect of PDT by topical drug for the treatment of juvenile onset laryngeal papillomatosis is encouraging. The principle of PDT and the principle of the recurrence of laryngeal papilloma in children were also introduced in this paper.
观察光动力疗法（PDT）治疗儿童期喉乳头状瘤的疗效。对28例喉乳头状瘤患儿进行治疗，初治仅2例，其余均在外院多次治疗，平均住院手术4次以上。在支撑喉镜及显微镜、内镜辅助下采用半导体激光、等离子及冷器械方法，直视下切除肿瘤，局部贴敷20% 5-氨基酮戊酸（光敏剂）3小时后，用635nm半导体激光进行光动力治疗，功率200 - 280mW，能量密度80～120J/cm²，照射20分钟。25天后重复PDT治疗直至无可见肿瘤，之后必须再进行2次PDT治疗。28例中，24例随访1年以上（12例随访3年），19例无复发，治愈率为79.2%（19/24）；5例复发，复发率为20.8%（5/24），其中2例因复发放弃治疗，另3例经3次PDT治疗后治愈。主要并发症为喉粘连。局部给药PDT治疗儿童期喉乳头状瘤初步效果令人鼓舞。本文还介绍了PDT原理及儿童喉乳头状瘤复发机制。
