Tracheal Haemangioma – Prevention of Tracheostomy by Early Nd:YAG-Laser Treatment

Objective: Hemangioma is a well-recognized cause of airway obstruction in infants with stridor. In former times tracheostomy was the only way in treating these life-threatening hemangiomas of the trachea. Due, to the possibility to transmit laser light with flexible fibres to the trachea, an early treatment of airway hemangiomas became possible.

Material& methods: We reviewed our experience with the use of laser therapy in treating airway hemangiomas. During the last eleven years (july 1996 until october 2007), 27 infants with airway hemangiomas underwent endoscopic Nd:YAG laser treatment.

Results: All of the twentyseven children treated with the Nd:YAG laser, seventeen showed regression of the hemangioma following a single laser treatment, the other ten children required repeated laser treatments. Three children needed artificial respiration for 24–48 hours after the treatment.

Discussion: All of the twentyseven children could be spared the intervention of a tracheostomy. During the same period of time, we treated 4 children with subglottic hemangiomas, that were previously cannulated. All children could be decannulated after one to 3 treatments.

Conclusion: If we compare the medical history of these both groups, the preoperative findings prior to tracheostomy respectively the first endoscopic laser procedure where comparable. These show that Nd:YAG laser therapy are effective in stabilizing the airway and prevent tracheostomy.