Variables que influyen en el pronóstico de la cirugía fotovaporización prostática mediante láser verde en el tratamiento de hiperplasia prostática benigna (HBP), en el servicio de urología del Hospital Carlos Andrade Marín / Influential variables in the prognosis of prostate photovaporization surgery through green laser in the treatment of benign prostatic hyperplasia in the Urology Department of HCAM

Introducción: Determinar los factores de riesgo preoperatorios e intraoperatorios que influyen en el resultado final de la intervención con láser verde KTP en pacientes con Hiperplasia prostática benigna. Materiales y Métodos: Se realizó un estudio retrospectivo en una cohorte de 153 pacientes con diagnóstico de Hiperplasia Benigna de Próstata (HBP), sometidos a cirugía mediante láser verde KTP y realizada desde mayo 2010 a septiembre 2013 en el Hospital Carlos Andrade Marín. Analizamos variables preoperatorias como edad, volumen prostático medido por ecografía, peso prostático por tacto rectal, PSA, antecedentes urológicos, antecedentes patológicos personales y clasificación ASA; así como variables intraoperatorias: tiempo quirúrgico y complicaciones. Resultados: Éxito quirúrgico ocurrió en el 59% de la muestra. En el análisis bivariado y multivariado, tanto el volumen prostático medido por ecografía (≥ 40 cm3) y las complicaciones intraoperatorias fueron significativas. Discusión: La fotovaporización con láser verde es una técnica implementada en nuestro medio para el tratamiento de HBP. Es preciso estudiar múltiples variables para predecir el éxito o fracaso de la intervención quirúrgica. Palabras clave: laser verde, hiperplasia prostática benigna, fotovaporización.

Introduction: To determine preoperative and operative risk factors that may influence the final outcome of prostatic surgery using KTP green laser in patients with Benign Prostatic Hyperplasia. Methods: Retrospective study performed within cohort of patients with Benign Prostatic Hyperplasia who underwent surgery using KTP greenlight laser, conducted between May 2010 to September 2013, at Carlos Andrade Marín Hospital. Several pre-operative variables were analyzed, among them: age, ultrasound, prostatic volume, prostatic weight assessed by rectal examination, PSA, urological history, medical history and ASA classification; and also intraoperative variables like surgical time and surgical complications. Results: Successful outcome was seen in 59% of treated patients. In the bivariate and multivariate analysis prostatic volume measured with ultrasound and intraoperative complications achieved significance. Discusion: Green laser photovaporization is a technique already implemented in our country for the BPH treatment. Multiple variables should be analyzed in order to predict surgical outcome.

Surgical Treatment of Sulcus Vocalis Using KTP Laser

Sulcus vocalis remains a surgical challenge despite many recent advances in laryngomicrosurgeries. We previously reported that 585-nm Pulsed dye laser (PDL) exerts favorable outcome in treatment of sulcus vocalis due to its therapeutic effects of collagen rearrangement and improved wound remodeling. In spite of the usefulness of PDL glottoplasty for treating sulcus vocalis, the device is no more available in the country. It prompted us to focus another angiolytic laser ; 532-nm KTP laser which has similar mechanisms of action and has been used for treatment of other laryngeal lesions elsewhere. Herein, we present a case of sulcus vocalis successfully treated with KTP laser. A patient underwent laryngomicrosurgery with angiolytic KTP laser (KTP glottoplasty) by the same surgical procedure with PDL glottoplasty. After the surgery, the patient presented improved voice outcome in time without complications.

Potassium-titanyl-phosphate (KTP) laser and dental bleaching: literature review / Láser potasio-titanil-fosfato (KTP) y blanqueamiento dental: revisión narrativa

Objective: To determinate if dental bleaching with KTP laser is a safe, effective and efficient technique. The use of KTP laser for dental bleaching was only investigated in combination with a high concentration of hydrogen peroxide (35 percent). The recommended protocol was: for the use of KTP laser at 3W power and an irradiation time of ten seconds, three to four cycles are needed. For a power of 1W and an irradiation time of thirty seconds the number of cycles is three with a maximum of four. Under these conditions KTP laser bleaching was considered not to alter surface morphology, to have no influence on enamel micro hardness, to maintain the pulp temperature within normal values, to obtain lighter tooth color which can be maintained for months (no long term studies were conducted). Because the bleaching effect was obtained in a short period of time and maintained for months, KTP laser bleaching was considered an effective and efficient technique. Conclusion: KTP-assisted dental bleaching is a safe, effective and efficient technique when combined with high concentration of hydrogen peroxide.

Objetivo: Determinar si el blanqueamiento dental con láser KTP es una técnica segura, efectiva y eficiente. El uso de láser KTP para blanqueamiento dental fue solo investigado en combinación con una alta concentración de peróxido de hidrogeno (35 por ciento). El protocolo recomendado fue: para el uso de láser KTP a 3W de potencia y un tiempo de irradiación de diez segundos, tres a cuatro repeticiones son necesarias. Para una potencia de 1W y un tiempo de irradiación de treinta segundos, el número de repeticiones son tres con un máximo de cuatro veces. Bajo estas condiciones, el blanqueamiento dental con esta técnica no altera la morfología de la superficie dental, no tiene influencia en la microdureza del esmalte, mantiene la temperatura pulpar dentro de valores normales y logra un color más claro el cual puede ser mantenido por meses (no se han realizado estudios a largo plazo). Conclusión: Debido a que, el efecto blanqueador se obtiene en poco tiempo y se mantiene por meses, el blanqueamiento dental con láser KTP se considera una técnica eficiente y efectiva, además de segura. Esto cuando es combinada con peróxido de hidrogeno de concentración alta.

Epidermoid Cyst: Case Report of an Unusual Location.

Aim: The aim of this study is to describe an unusual case of an Epidermoid Cyst (EC) of the tongue treated by a Potassium Titanium Phosphate (KTP) laser. Presentation of Case: A 38 young male patient came to our attention since a little painless swelling, yellowish, on the lateral left side of the tongue. After an accurate clinical examination, a surgical excision with a KTP laser was performed. Control at 7 and 21 days showed a complete healing of lesion and the histological diagnosis was EC. Discussion: EC generally appear like a firm, usually painless swelling that sometimes raises the tongue. In the differential diagnosis of the EC the clinician has to consider a wide range of pathologic conditions that could be classified as development, neoplastic and infective pathologies. Surgical enucleation is the only effective treatment for these kinds of lesions and prognosis is very good, with a very low incidence of relapse. Conclusion: Several techniques are reported in the literature but the use of KTP laser for the excisional biopsy of ORAL EC is very effective, since the relative ease and speed of execution, the compliance of patience, the absence of bleeding and suture.

Can 80 W KTP Laser Vaporization Effectively Relieve the Obstruction in Benign Prostatic Hyperplasia?: A Nonrandomized Trial

PURPOSE: There is little data evaluating the changes of severity of bladder outlet obstruction after 80 W-potassium-titanyl-phosphate (KTP) photoselective laser vaporization prostatectomy (PVP) by pressure-flow study. We evaluated the efficacy of PVP to relieve the obstruction in benign prostate hyperplasia (BPH) compared with transurethral resection of the prostate (TURP). MATERIALS AND METHODS: This is a prospective, non-randomized single center study. The inclusion criteria were as follows: Men suffering from lower urinary tract symptoms (LUTS) secondary to BPH, age > or =50 years, International Prostatic Symptom Score (IPSS) > or =13, maximum flow rate (Qmax) or =40 was decreased from 64% to 4% in the PVP group and from 86% to 14% in the TURP group. CONCLUSIONS: PVP could reduce the prostate volume effectively and relieve bladder outlet obstruction similar to TURP by the 6-month follow up in men with BPH.

Impact of Prostate Volume on the Efficacy of High-Power Potassium-Titanyl-Phosphate Photoselective Vaporization of the Prostate: A Retrospective, Short-Term Follow-Up Study on Evaluating Feasibility and Safety

PURPOSE: We determined the impact of prostate volume on the efficacy of the high-power (80 W) potassium-titanyl-phosphate (KTP) photoselective laser vaporization of the prostate in men with lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: Patients were stratified into 3 groups according to prostate volume: ' or = 60 g' (n = 22). Median follow-up was 9 months (range 6 to 21). RESULTS: No differences in age and follow-up duration were observed in the three groups. At baseline, no significant differences were noted in the three groups in terms of the International Prostate Symptom Score (IPSS) (21.4, 19.4 and 19.1; p = 0.412) as well as the maximum flow rate (Qmax) (10.2, 9.2, and 8.6 mL/s; p = 0.291) and post-void residual (PVR) (66.2, 80.4, and 71.5 mL; p = 0.856). The mean operative times were 30.9, 46.9, and 58.6 minutes (p < 0.001) and total median energy deliveries for each group were 62.3, 97.6, and 135.9 kJ, respectively (p < 0.001). No severe intraoperative complication was observed. At the last follow-up, these parameters improved significantly regardless of prostate volume, and the IPSS (11.1, 9.4, and 12.3; p = 0.286) as well as Qmax (15.9, 15.9, and 14.2 mL/s; p = 0.690) and PVR (33.7, 28.4, and 14.2 mL; p = 0.395) were not significantly different among the groups. CONCLUSION: Although a larger prostate requires more time and energy delivery, photoselective laser vaporization of the prostate is safe and efficacious for patients with LUTS regardless of prostate volume.

A Case of Angiokeratoma Treated with a 532 nm KTP (Potassium-titanyl-phosphate) Laser / 대한피부과학회지

Angiokeratomas are cutaneous vascular lesions that are characterized by dilated thin-walled blood vessels that lay in the upper part of the dermis, and this condition is mostly associated with epidermal reactions such as acanthosis, hyperkeratosis and elongation of rete ridges. Four variants have been described (angiokeratoma of Fordyce, angiokeratoma of Mibelli, angiokeratoma corporis diffusum, and solitary or multiple angiokeratomas). Among these variants, angiokeratoma of Fordyce develops mainly in elderly Caucasian men and it is common on the genitalia. Angiokeratomas are blue to purple, smooth, 2- to 5-mm papules on the scrotum, penile shaft or glans. They generally appear to multiply during life, but they occasionally present as single lesions. They may bleed after trauma and they may be mistaken for a nevus, melanoma or Kaposi sarcoma. Electrocautery or laser ablation can be offered for treatment. Various studies have recently reported successful treatment with argon laser, copper vapor laser, variable pulse width 532 nm neodymium:yttrium-aluminium-garnet (Nd:YAG) laser, 532 nm KTP (potassium-titanyl-phosphate) laser and flashlamp-pumped pulsed dye laser (PDL). We report here on a case of angiokeratoma that was treated with a 532nm KTP laser.

Potassium-Titanyl-Phosphate Laser Photoselective Vaporization of the Prostate in Patients with Benign Prostatic Hyperplasia with Detrusor Underactivity: Influence on Detrusor Pressure

PURPOSE: Potassium-titanyl-phosphate laser photoselective vaporization of the prostate (PVP) is a safe and effective treatment for patients with symptomatic benign prostatic hyperplasia (BPH). The aim of this study was to assess the influence and the effect of PVP in BPH patients with detrusor underactivity. MATERIALS AND METHODS: We evaluated 21 patients with detrusor under-activity treated with PVP for BPH from January 2006 to December 2007. Detrusor underactivity was defined as detrusor pressure at maximal flow rate (Qmax) of less than 30 cmH2O and Qmax of less than 15 ml/s. Urodynamic studies were performed and international prostate symptom score (IPSS) and quality of life (QoL) scores were assessed preoperatively and at 6 months postoperatively. RESULTS: There were significant improvements in Qmax, voiding urine volume, post-void residual urine volume, IPSS, and QoL scores at 6 months after PVP treatment. However, patients did not show significant changes in maximal bladder capacity, bladder compliance, or detrusor pressure at Qmax. CONCLUSIONS: Even though BPH patients had detrusor underactivity, PVP was an effective surgical procedure. However, PVP did not make any significant difference on detrusor pressure at Qmax in 6 months.

The Effectiveness of Transurethral Resection of the Prostate Combined with High Power Potassium-titanyl-phosphate(KTP) Laser Vaporization for Patients with a Prostate Volume Greater than 45cc / 대한비뇨기과학회지

PURPOSE: We compared the effectiveness of transurethral resection of the prostate(TURP) with the effectiveness of high power potassium-titanyl-phosphate(KTP) laser vaporization combined with TURP in patients with a prostate volume over 45cc. MATERIALS AND METHODS: Between March 2004 and March 2007, we analyzed all the patients with a prostate volume over 45cc and who underwent TURP or KTP laser vaporization combined with TURP for treating symptomatic benign prostatic hyperplasia(BPH). The patients were divided into two groups(Group I: TURP: n=53, Group II: KTP laser vaporization combined with TURP: n=54). The initial evaluation included a digital rectal examination, urinalysis, determining the hemoglobin, electrolyte and prostate-specific antigen(PSA) levels, the International Prostate Symptom Score(IPSS), the quality of life(QoL), the maximum urine flow rate (Qmax), the postvoiding residual urine(PVR), transrectal ultrasonography (TRUS) and urodynamic study. The postoperative hemoglobin and electrolyte levels were checked promptly, and the total operation time, the foley indwelling period and the number of hospital days were recorded afterwards. The IPSS, QoL, Qmax, and PVR were evaluated at 1 and 3 months postoperatively. RESULTS: The baseline characteristics and postoperative outcomes of the two groups were similar. The total blood loss during operation was significantly lower in Group II(p=0.02). CONCLUSIONS: KTP laser vaporization combined with TURP resulted in less blood loss than TURP and it provided a good operation field in those patients who have over 45cc of prostate. Thus, KTP laser vaporization combined with TURP is safer than performing only TURP.

La vaporización fotoselectiva del adenoma prostático con el ktp-láser (kalium-titanyl-phosphat) de 80 watt y la RTU-P de baja presión hidráulica / The photoselective vaporization of prostate adenoma with the 80 watt ktp-laser (kalium-titanyl-phosphat) and the low hydraulic pressure tur-p

El objetivo de este trabajo prospectivo es determinar la eficacia del método KTP-láser de 80 watt para la vaporización y ablación de la HPB sintomática. También se analizan los resultados al combinar el KTP-láser con la RTU-P y su repercusión sobre la hemoglobina. Material y Método: 300 pacientes con HPB sintomática fueron tratados entre agosto del 2004 y noviembre del 2006 con el KTPláser o combinado con RTU-P. La resección adicional fue efectuada en pacientes con adenomas grandes o por lóbulo medio acentuado. El efecto ablativo fue controlado al final de la operación por medio de TRUS. Resultados: 300 pacientes fueron tratados en 2 grupos. El grupo 1 (n: 50) con sólo tratamiento láser y pequeños adenomas, la hemoglobina se redujo un 3,2 por ciento y nadie requirió una transfusión. El grupo 2 (n: 250) con tratamiento combinado de KTP-láser y RTU-P en adenomas grandes, la hemoglobina se redujo en promedio 15,2 por ciento después de la intervención; 2 pacientes (0,8 por ciento) necesitaron una transfusión. Conclusión: El estudio pone de manifiesto, las ventajas de combinar ambos procedimientos quirúrgicos para obtener un mejor resultado en la ablación del adenoma sobre todo en próstatas de gran tamaño.

The objective of this prospective study is to determine the effectiveness of the 80 watt KTP laser method for the vaporization and ablation of the symptomatic BPH. Also the results when combining the KTP-laser with the TUR-P and their repercussion on the haemoglobin are analysed. Material and Method: 300 patients with symptomatic BPH were treated between august 2004and november 2006 with the KTP-Laser or combined with TUR-P. The additional Resection was carried out in those patients with great adenomas or to have accentuated middle lobule. The ablative effect was controlledat the end of the operation with TRUS (transrectal ultrasound). Results: 300 patients were treated in 2 groups. The group 1 (n: 50) just by laser treatment and small adenomas, the haemoglobin was reduced a 3.2 percent and nobody required a transfusion. Group 2 (n: 250) with combined treatment of KTP-laser and TURP in great adenomas, the haemoglobin was reduced in average 15,2 percent after the intervention; 2 patients (0,8 percent) needed a transfusion. Conclusion: Our study puts of open, the advantages to combine both surgical procedures to mainly obtain a better result in the ablation of the prostate adenoma in prostates of great size.

Application of Potassium Titanyl Phosphate (KTP) Laser Delivered via Bronchofiberscope in the Treatment of Endobronchial Tuberculosis / 华中科技大学学报（医学）（英德文版）

To explore the application of potassium titanyl phosphate (KTP) laser delivered via bronchofiberscope in the treatment of endobronchial tuberculosis. 36 patients with a diagnosis of endobronchial tuberculosis, with age ranging from 15 to 40 y were treated with KTP laser between Dec. 2002 and July 2004 (designated as treatment group). The other 36 patients diagnosed as having endobronchial tuberculosis (aged 18 to 42 y, with a mean age of 33. 5 y) without having received KTP laser treatment were included in a control group. Our results showed that the effective rates, in terms of recovery of bronchial lumen and cleanup of caseous necrotic mass were significantly higher in the treatment group 8 weeks after the treatment (P＜0.01), and the healing rates of atelectasis and obstructive infection were also significantly higher in the treatment group (P＜0.05 and P＜0.01), but the incidence of complication after 8 weeks was no significant difference (P ＞0.05). No significant changes were found in SaO2 and HR before, during and after the operation in the treatment group (P＞0.05). It is concluded that KTP laser is an effective therapy for endobronchial tuberculosis.

Photoselective Vaporization of the Prostate(PVP) using KTP Laser for Treatment of Benign Prostatic Hyperplasia(BPH) / 대한남성과학회지

PURPOSE: PVP using a high-power potassium-titanly-phosphate(KTP) laser offers safe and efficacious surgical therapy for men with symptomatic BPH. To demonstrate its efficacy, safety and durability, we present the results of PVP for treatment of BPH with 12 month follow-up. MATERIALS AND METHODS: 104 consecutive men with symptomatic BPH underwent PVP with an 80 W KTP laser (Laserscope) between July 2003 and August 2004. All underwent preoperative and postoperative evaluation, including assessments of international prostate symptom score(IPSS), quality of life(QOL), peak urinary flow rate(Qmax), post-void residual volume(PVR), prostate specific antigen(PSA), and ultrasound prostate volume(PV). Secondary outcome parameters included surgical time, anesthesia, and length of catheterization. Follow-up assessment occurred at 1, 3, 6, and 12 months. Data were analyzed using the Wilcoxon signed rank test. RESULTS: Preoperative mean PV was 57.2+/-4.2 ml. PV decreased to 38.9, 35.4, 32.8 and 35.8 at 1, 3, 6 and 12 months (p <0.01 versus preoperative value). Mean improvements in IPSS, QOL, Qmax, and PVR at 12 months were 67%, 81%, 138% and 94%, respectively(p <0.001). Mean operative time was 26.3+/-15.0 minutes. Anesthesia included pudendal and prostatic block(n=102) and spinal anesthesia(n=2). Ninety-nine(95%) patients were treated as outpatients( <12 hrs) and the remaining 5 patients were admitted for 1 or 2 hospital days. Mean catheterization times were 9.8+/-3.1 hours(range 0~72), with 28(27%) patients not requiring a catheter post-operatively. Minor complications included mild hematuria lasting 3 weeks(3.8%), transient post-operative retention(2.9%), urge incontinence(1.9%), transient dysuria(25%), frequency(21.2%), urgency(17.3%) and retrograde ejaculation(41%). CONCLUSIONS: These results demonstrate that PVP is safe and efficacious for the treatment of symptomatic BPH. Long follow-up will further validate this new modality as the standard for surgical treatment of BPH.

KTP-Nd: YAG laser-assisted dacryocystoplasty for lacrimal duct obstruction / 第三军医大学学报

Objective To evaluate the therapeutic efficacy of KTP Nd: YAG laser assisted dacryocystoplasty for lacrimal duct obstruction. Methods Specially made hollow lacrimal probe was used to examine the lacrimal ducts to the obstructed parts in a total of 827 eyes. Then KTP laser fibers were inserted into the lacrimal ducts to dredge the obstructed parts by laser. Instillation of different drugs or short term placement of lacrimal supporters was conducted after operation according to the symptoms such as degree of obstruction and with discharges or not. Results The cure rate, improvement rate, and ineffectiveness rate were 93.5%, 5.5%, and 1%, respectively. One therapy was conducted in 562 eyes, twice in 191 eyes. Conclusion KTP Nd: YAG laser assisted dacryocystoplasty is a safe and effective way for the treatment of lacrimal obstruction. Postoperative drug instillation or short term placement of lacrimal supporter can contribute to the clinical outcomes.

Microscopic Partial Tonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Conventional tonsillectomy with the naked eye has posed problems in obtaining a good surgical field and in minimizing damage to the adjacent tissue. Tonsillectomy using an operating microscope offers outstanding illumination and visualization of the surgical field, thereby reducing the incidence of complications associated with tonsillectomy. The objective of this study was to compare the surgical methods of the conventional and the microscopic tonsillectomies, and to evaluate the usefulness and effectiveness of the microscopic tonsillectomy. MATERIALS AND METHODS: Two hundred children between the ages of five and ten who received tonsillectomy between June 1995 and August 1998 at Korea University Hospital were divided into two groups,' one group underwent tonsillectomy using an operating microscope (Group 1, n=100) and the other group underwent tonsillectomy using the conventional dissection and snare technique (Group 2, n = 100). Duration of surgery, post-operative healing period, amount of intra and post-operative hemorrhage, post- operative pain score, and the incidence of post-operative cicatrical pharyngeal stenosis were compared between the two groups. RESULTS: There was no statistically significant diference in operating time and post-operative healing period between the two groups, but cicatrical pharyngeal stenosis due to post-operative scarring was more common in the group that underwent conventional tonsillectomy. The amount of hemorrhage both intra and post-operatively, and post-operative pain was significantly decreased in the microscopic tonsillectomy group. CONCLUSION: The widespread use of operating microscope in otolaryngological surgeries allows this technique to be applied to tonsillectomy with few problems. This technique affords decreased intra-operative bleeding, less post-operative complications, and decreased post-operative pain compared with conventional techniques. We believe that microscopic tonsillectomy is a safe, elegant and effective procedure that represents a new concept in tonsil surgery.

Laser Assisted Partial Adenotonsillectomy in Children / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In children, adenotonsillectomy is performed for treating recurrent tonsillitis, mouth breathing and sleep disorder. However, there are some complications associated with the complete removal of the tonsil and adenoid. The conventional method involving dissection and snare techniques used for adenotonsillectomy has been the subject of debate over its indications and appropriate time for surgery, since it removes most of the tonsil tissues and may have destructive effect on the local defense mechanism. The aim of this study was to analyze the results of laser assisted partial adenotonsillectomy by using KTP-532 laser to preserve minimal amount of tonsil tissue needed for the local defense mechanism. MATERIALS AND METHODS: Sixty cases of laser assisted partial adenotonsillectomy, and sixty cases of conventional adenotonsillectomy with dissection and snare techniques were examined. RESULTS: There were no differences regarding the recurrence rate, improvement of symptoms, and degree of postoperative pain between the laser partial adenotonsillectomy group and the conventional groups. There were less incidence of preoperative bleeding and postoperative scar formation in the laser partial adenotonsillectomy. CONCLUSION: Compared to the conventional method, the laser assisted partial adenotonsillectomy has a similar incidence of postoperative result but a low incidence of preoperative complications such as bleeding. It also preserves minimal tonsil tissues responsible for local defense mechanism. We suggest that the laser assisted partial adenotonsillectomy is an attractive surgical method in children.

Treatment of Posterior Epistaxis with Posterior Endoscopic Laser Photocoagulation / 대한이비인후과학회지

Epistaxis is a common otolaryngologic emergency. Posterior epitaxis is more frequent in the elderly and associates with hypertension and arteriosclerosis. This is apt to be more vigorous in volume, is more difficult to identify the active bleeding point, and is more troublesome to contol. A number of different treatments are used to control the posterior epistaxis. Some of these are deep anterior packing, posterior packing, nasal balloon tamponade, arterial ligation, arterial embolization and posterior endoscopic cautery. Recently we directly photocoagulated the bleeding points in 7 cases of posterior epistaxis using endoscope and KTP/532 laser. The epistaxis was controlled in all cases without any significant complication.

Management of Congenital Choanal Atresia with the KTP/532 Laser / 대한이비인후과학회지

Congenital choanal atresia is an uncommon anomaly. In most reported series it has an incidence of 1 in 7,000 or 80,000 births with female preponderance. Approximately 90% of cases are reported as having unilateral bony type congenital atresia. Bilateral congenital choanal atresia cause acute life-threatening respiratory obstruction in newborns, whereas unilateral atresia alone does not cause significant airway obstruction. Rarely an infant may compensate by rapidly learning mouth breathing and the diagnosis may escape detection for months or even years. A variety of techniques are available to correct this problem, but none is entirely satisfactory. The authors recently experienced a case of unilateral membranous type congenital choanal atresia which was treated by KTP/532 laser and report the case with review of literatures.