Kamil Sara, Mohsen Samer
Department of Otolaryngology, Faculty of Medicine, Damascus University, Damascus, Syria.
Department of Audiology, Faculty of Health Sciences, Damascus University, Damascus, Syria.
Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):536-539. doi: 10.1007/s12070-023-04205-2. Epub 2023 Sep 25.
Juvenile recurrent respiratory papillomatosis (JRRP) is the most common benign tumor in the larynx. It is uncommon; however, it is potentially life-threatening because it compromises the respiratory tract and required several surgeries to manage recurrences. Currently, the carbon dioxide laser is the treatment of choice. There are no studies about the role of the diode laser which is easy to use and has lower usage cost. This case series presentation reported on the therapeutic effects and recurrence rate of JRRP when using Diode laser. This is a case series presentation of 13 children, who were diagnosed with JRRP and operated for laryngeal papillomatosis with Diode laser in Otorhinolaryngology and Head and Nick Surgery Department et al. Mouwasat Hospital, Damascus, Syria between 2015 and 2022. 13 children required 56 surgeries at a rate of 1-2 surgeries/year, mean number of surgeries for each child was 4.31. That suggests that Diode laser might have a role in reducing the number of surgeries compared to a study used cold instrument and CO laser. The complications rate was 30.8%, which is considered a high rate compared to the other studies. In conclusion, we encourage using it when the CO laser device is not available. However, we suggest, reducing the power as low as possible and avoiding of two opposing raw surfaces, especially at the anterior commissure and deep excision. Further longitudinal studies are recommended to validate these results.
青少年复发性呼吸道乳头状瘤病（JRRP）是喉部最常见的良性肿瘤。它并不常见；然而，它可能危及生命，因为它会影响呼吸道，并且需要多次手术来处理复发情况。目前，二氧化碳激光是首选的治疗方法。关于易于使用且使用成本较低的二极管激光的作用，尚无相关研究。本病例系列报告了使用二极管激光治疗JRRP的治疗效果和复发率。这是一个包含13名儿童的病例系列报告，这些儿童在2015年至2022年期间于叙利亚大马士革穆瓦萨特医院耳鼻喉科及头颈外科等科室被诊断为JRRP，并接受了二极管激光治疗喉乳头状瘤手术。13名儿童共需要56次手术，手术频率为每年1 - 2次，每个儿童的平均手术次数为4.31次。这表明与一项使用冷器械和CO激光的研究相比，二极管激光可能在减少手术次数方面发挥作用。并发症发生率为30.8%，与其他研究相比，这被认为是一个较高的发生率。总之，当没有二氧化碳激光设备时，我们鼓励使用它。然而，我们建议尽可能降低功率，并避免两个相对的创面，尤其是在前联合处和深部切除时。建议进行进一步的纵向研究以验证这些结果。
