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.