Endoscopic carbon dioxide laser surgery for laryngeal papillomatosis.:An attempt of two-stage operation

概要

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There are many kinds of therapeutic methods for laryngeal papilloma. However, it is even now exceedingly difficult to eradicate lesions completely. Recurrences after surgery occur frequently. One of the causes of recurrences is considered to be an incomplete removal. We believe an incomplete removal of papilloma is caused by lack of precise visualization of the lesion during surgery. Bleeding, coagulated blood and/or carbonized tissue produced by laser obscures the image of remaining papilloma. We have developed a new surgical method, called "tow-stage operation". Two successive surgeries are conducted with an interval of 10 days. At the second operation, bleeding, coagulated blood and carbonized tissue of the first operation disappear and the laryngeal image is much clearer. When some lesions are still found, they are removed at the second operation. This paper presents a case of 26-year-old male with laryngeal papilloma who had been operated one month before at another hospital. A laryngeal endoscopic examination revealed multiple papillomas especially at the glottis. The first surgery was performed with carbon dioxide laser on 16th Apr. 1990. Visible lesions appeared to be removed completely. The second operation was carried out 10 days after the first operation and small remaining lesions was removed with CO<SUB>2</SUB> laser. The patient has been disease free for eight months.
The Japan Laryngological Associationの論文