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The Application of the Potassium-Titanyl-Phosphate (KTP) Laser in the Management of Subglottic Hemangioma
David Madgy, DO;
Syed F. Ahsan, MD;
Darren Kest, DO;
Ira Stein, MD
Arch Otolaryngol Head Neck Surg. 2001;127:47-50.
Background Subglottic hemangioma is the most common neoplasm of the infant airway.
Most lesions involute spontaneously; however, some may grow to cause life-threatening
respiratory tract distress. The standards of treatment have been tracheotomy,
corticosteroids, and laser vaporization. However, use of the carbon dioxide
laser has been associated with increased risk of damage to adjacent mucosa
and an increased risk for the development of subglottic stenosis postoperatively.
Objective To review our experience with the use of the potassium-titanyl-phosphate
laser in the treatment of subglottic hemangioma.
Patients and Methods A retrospective review of 6 patients with subglottic hemangioma treated
with the potassium-titanyl-phosphate laser was carried out at a tertiary care
children's hospital. Patients' medical charts were evaluated for factors such
as age, sex, degree of airway obstruction, location of hemangioma, number
of laser procedures performed, and postoperative results, including short-
and long-term complications.
Results All 6 patients had significant relief of airway obstruction after use
of the potassium-titanyl-phosphate laser. Five of the patients had localized
disease, and one had circumferential subglottic involvement. The average number
of procedures was 1.7. There were no intraoperative complications. One patient
had prolonged intubation following surgery, and only one developed grade 1
subglottic stenosis requiring dilation. Long-term results have been promising
in that all patients are asymptomatic and follow-up laryngoscopy and bronchoscopy
have shown complete resolution of the hemangioma.
Conclusion The potassium-titanyl-phosphate laser can be used to provide significant
clinical relief of airway obstruction due to grade 1 and 2 subglottic hemangioma,
with minimal complications.
From the Department of Pediatric Otolaryngology, Children's Hospital
of Michigan, Detroit (Drs Madgy, Kest, and Stein); and the Department of Otolaryngology–Head
and Neck Surgery, Wayne State University, Dearborn, Mich (Dr Ahsan).
Corresponding author: Syed F. Ahsan, MD, Department of Otolaryngology–Head
and Neck Surgery, Wayne State University, 4941 Heather Dr, Apartment 105,
Dearborn, MI 48126 (e-mail: Sydahsan{at}aol.com).
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