Co2 laser in treatment of laryngoscleroma: preliminary study

Twelve patients proved histopathologically to have rhinoscleroma were treated with CO2 laser. They were five patients in the fibrotic stage, six in the granulomatous stage and one patient in the healed fibrotic stage in one side of the nose and granulomatous in the other. In fibrotic lesions, pulsed and superpulsed modes were used with 18 to 20 watts, while in granulomatous lesions continuous mode with 20 to 25 watts were used. All patients complained of bilateral complete persistent nasal obstruction. All patients were operated upon under general anesthesia apart from one with cardiac ischemia who was operated upon under local anesthesia. The procedure could be well tolerated. Three patients with extensive lesions involving the choanae needed two sitting. No immediate complications were met with apart of insignificant burns to the vestibule unilaterally in only three patients. No bleeding apart of slight bleeding in one granulomatous lesion was found. Nasal patency was achieved bilaterally in all patients who were followed up for at last one year except of a girl with extensive granulomatous lesion involving the choana and nasopharynx. CO2 laser is a valid and safe adjuvant to the treatment of scleroma in the fibrotic stage. In patients with extensive granulomatous lesions with involvement of the choana and nasopharynx, CO2 laser could be used to debulk the lesions in combination to conventional surgery. This could shorten the time and limit laser use