ABSTRACT
Airway obstruction during infancy and childhood requiring surgical ablation is rare, and surgical intervention poses a significant challenge. During recent decades, appropriate endoscopic instrumentation, together with advanced laser beam technology have provided new operative modalities for such patients. From 1993 to 1995 we treated 40 infants and children, 26 males and 14 females, 13 days to 11 years old (mean 3.3 years) with Nd-YAG or CO2 laser. Obstructing lesions included granulation tissue or polyps (16 cases), septa or webs (27), or benign tumors (4). 7 had more than a single lesion. All were treated endoscopically under general anesthesia without any operative or postoperative deaths. Surgical intervention removed the obstruction and related symptoms in 34. In 6, laser treatment failed, necessitating additional surgical procedures. 3 had circumferential subglottic web. Operative complications included bleeding during removal of a hemangioma in 1 and recrudescence in another. Postoperative complications were transient respiratory failure and pneumonia in 6, all of which resolved with appropriate treatment. This series proves that laser technology is feasible in the treatment of airway obstruction during infancy and childhood, and is safe and effective.
Subject(s)
Airway Obstruction/surgery , Laser Therapy , Airway Obstruction/classification , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Intraoperative Complications , Male , Postoperative Complications , Retrospective StudiesABSTRACT
Bilateral involvement of the temporal bones is a rare manifestation of eosinophilic granuloma, a disease characterized by solitary or multiple foci of osteolytic damage. We report two cases in which the ambiguous and unusual initial symptoms and clinical course constituted a difficult diagnostic problem. In each case, the therapeutic approach used was different: the first was treated with a combination of radiotherapy and corticosteroids and the second with a combination of chemotherapy and corticosteroids. We have reviewed the literature, and the possible symptoms and clinical course are described. We report our views on the diagnostic and therapeutic aspects of the disease.
