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Severe laryngeal dysplasia in a 20-year-old nonsmoker treated with CO2 laser excision: a case report and review of the literature.
MedLine Citation:
PMID:  20860544     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: We present the unusual case of a 20-year-old female nonsmoker with severe laryngeal dysplasia managed with endoscopic CO(2) laser resection with frozen-section analysis. We use her case as a platform for discussion of the current evidence surrounding laryngeal dysplasia, particularly etiology and the use of lasers in management.
BACKGROUND DATA: Laryngeal dysplasia represents a series of progressive epithelial changes that can eventually lead to invasive laryngeal carcinoma. Typically, most patients are male, in their 50s or 60s, and are smokers; to our knowledge our patient represents the youngest reported case of this condition in a woman with no established risk factors. We discuss the implications of this on her subsequent management with the CO(2) laser.
METHODS: With the help of intraoperative photographs, we describe our excisional technique with the CO(2) laser, model 315M Superpulse class 4 (Irradia AB, Stockholm, Sweden) at a 6-W continuous power setting.
RESULTS: At 6 months after surgery, our patient remains disease free with good voice quality.
CONCLUSIONS: Our patient appears to defy all the usual etiologic stereotypes that usually govern the development of laryngeal dysplasia. CO(2) laser excision plus intraoperative frozen-section analysis remains a safe and reliable method for the treatment of laryngeal dysplasia; the reassurance of histologically clear margins minimizes the extent of radical laser excision necessary and provides good functional results. We provide a comprehensive overview of the current literature on laryngeal dysplasia etiology and treatment, particularly the use of lasers in management.
Authors:
Lyndsay Fraser; Gerard Kelly; Kenneth MacLennan; Zvoru G G Makura
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Publication Detail:
Type:  Journal Article     Date:  2010-09-23
Journal Detail:
Title:  Photomedicine and laser surgery     Volume:  28 Suppl 2     ISSN:  1557-8550     ISO Abbreviation:  Photomed Laser Surg     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101222340     Medline TA:  Photomed Laser Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S115-9     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology, Pinderfields General Hospital, Aberford Road, Wakefield, England. LyndsayFraser@doctors.org.uk
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