[CO2 laser treatment in laryngeal papillomatosis]

Laryngeal papillomatosis is a rare, unpredictable pathology which often recurs. Although several forms of surgery have been suggested for this pathology, CO2 laser surgery is the treatment of choice. This paper presents 30 cases of laryngeal papillomatosis, 12 of which arose in infancy, all treated by dissection and/or CO2 laser vaporization. The treatments were performed in one or more stages depending on the site and appearance of the lesions. Special care must be taken to preserve the anatomical integrity when a papillomatosis must be removed from the glottic area. The average number of surgical procedures per patient proved greater in multifocal vs. unifocal forms (4.7 vs. 1.6) and in children vs. adults (4.9 vs. 3.7). In four patients the pathology followed a neoplastic evolution. Today 57% of the subjects treated (17) are in clinical remission after an average 17 month follow-up. CO2 laser endoscopic microsurgery is presently the most suitable method for treating laryngeal papillomatosis although the biological features of this diseases often make treatment difficult.