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Laryngeal papillomatosis with airway obstruction in an infant
1Department of Anaesthesia and Medical Imaging, Trondheim University Hospital, Norwegian University of Science and Technology, Olav Kyresgate 17, No-7006 Trondheim, Norway. peter.mikkelsen@rit.no
Insights
Laryngeal papillomatosis, a recurring throat tumor in children, can cause breathing issues. This case highlights a novel laser treatment approach to potentially reduce the need for tracheotomy in infants.
Area of Science:
- Pediatric Otolaryngology
- Respiratory Medicine
Background:
- Laryngeal papillomatosis is a benign but recurrent condition in infants and children.
- Tumor location and recurrence pose significant risks to the airway.
Observation:
- A case report details a 17-month-old girl with congenital hoarseness and wheezing due to laryngeal papillomatosis.
- The tumor necessitated a tracheotomy to secure her airway.
Findings:
- The study discusses symptoms, differential diagnoses, and emphasizes suspecting laryngeal papillomatosis in infants with chronic hoarseness and wheezing.
- Laser treatment, specifically potassium titanyl phosphate (KTP) laser, is explored as a therapeutic option.
Implications:
- Using a laryngeal mask airway during KTP laser treatment may avoid tracheal intubation and reduce the risk of disease spread.
- Further research is needed to determine if this technique can decrease tracheotomy rates in pediatric patients.
Abstract:
Laryngeal papillomatosis in infants and children is a benign condition, but the location and a marked tendency for recurrence makes the disease both dangerous and troublesome. This case report deals with a little girl who had suffered hoarseness and wheezing since she was born. The diagnosis of laryngeal papillomatosis was made when she was 17 months old. By that time, the tumour had reached a size that necessitated a tracheotomy to secure the airway. The symptoms and differential diagnoses are discussed, and it is stressed that chronic hoarseness and wheezing sounds in infants and children should make a doctor suspect laryngeal papillomatosis. Laser treatment and anaesthetic management of small children with a compromised airway are discussed. As tracheal intubations and tracheotomy increase the risk of the disease spreading to the trachea and bronchi, an example is given of treating laryngeal papillomatosis with potassium titanyl phosphate (KTP) laser, using a laryngeal mask as an airway to avoid tracheal intubation. Whether this procedure can reduce the need to perform a tracheotomy in some of these small patients remains to be seen.