gms | German Medical Science

Introduction: Using of cold instruments in laryngeal papillomas removal frequently leads to intraoperative bleeding and postoperative scarification of rimma glottitis.

Material and methods: To prevent scarification of rima glottitis in patients with laryngeal papillomatosis we apply Laser Interstitial Thermo Therapy (LITT) technique. 24 patients (16 female, 8 male) underwent surgery accordingly with the aforementioned mode of laser application. Indirect laryngoscopy, fibrolaryngoscopy, videofibrolaryngoscopy with different modifications and functional tests, the voice computer analysis, spirometry as well as morphological, virological and immunological methods were applied for patient’s examination.

Results: The concept of LITT consists of protein denaturation in the target area due to the applied heat in the range of 56–70o C. The technique is based on contact mode of laser action. Not only denaturation, but apoptosis is also the intimate mechanism cell degradation. The LITT technique was applied in cases of disseminated pathological process and in the area of the anterior laryngeal comissure. Visually milky white color of the papillomas indicated the final stage of LITT.

Conclusions: The integrity of basal membrane is preserved, hence, providing for no scarring, the surgery is bloodless and induces no inflammation in postop period. The technique provides radicality compared with the another methods of intervention. 24 patients underwent surgery accordingly with the aforementioned mode of laser application. Massive papillomatosis of the anterior comissure was successfully treated. All of them at the follow-up showed no scarring or any other complication.

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