Clinical Application Of Intra-tumor Ablation Surgery Treating Hemangioma In Pharynx With Ho: YAG Laser

BACKGROUND:The hemangioma is one of the most common benign tumor of soft tissiue,of which 60%are situated on head and neck.Most of them are dermatic or hypodermal hemangiomas,only a few of them are pharyngeal hemangiomas.Although hemangioma is benign,it could also destroy the partial constitution because of incessant growing.The pharyngeal hemangiomas can affect normal function of organs,such as breath,vocalization,swallow et al;hemorrhage,infection and ulcer may occasionally occur.At present,there are lots of kinds of treatments on hemangioma,such as injection of sclerosing agent or pingyangmycin,operation,laser or combined therapy. Holmium:YAG laser(Ho:YAG) is a kind of iraser which is produced by yttrium aluminium garnet laser mixed with holmium.With its excellent character,Ho:YAG laser had been used in more and more areas of medicine.However there is no report about Ho:YAG laser used in hemangioma therapy untill now.PURPOSE:The study which aims at the therapeutic efficacy and the prevention of complications,retrospectively analyzes 15 cases pharyngeal hemangiomas cured by Intra-tumor Ablation Surgery using Ho:YAG laser in Sir Run Run Shaw Hostiptal the affiliated hospital of Zhejiang university.METHOD:Between January 2002 and January 2009,15 patients with pharyngeal hemangiomas were treated by Ho:YAG laser in the ENT department,Sir Run Run Shaw Hostiptal the affiliated hospital of Zhejiang university.RESULTS:1.Clinical data:The sex ratio is 2:1.The youngest patient is 22,while the oldest is 80.Location:oropharynx(5 cases),laryngopharynx(9 cases),both oropharynx,laryngopharynx and vocal cord(1 case).The biggest tumor involves the whole laryngopharynx,while the smallest tumor's diameter is 1.5cm.All patients are general anaesthesia with trachea intubation.With the help of microscope,the surgeon can put the optical fiber into hemangiomas and ablate them using Ho:YAG laser.One of them who has a giant hemangioma,received Pingyangmycin injection before ablation, while 10 cases combined Pingyangmycin injection after that.2.Therapeutic Effect Observation:During the procedure of Ho:YAG laser gasifying hemangiomas,we can see hemangiomas collapsing and drying up,with crust left.After 2 weeks there is only superficial scar,no scar contracture,no dysfunction.Among the total,14 cases are cured(93.33%),1 case of giant hemangioma is elementary cured(6.67%).The total effective rate of hemangiomas was 100%.3.Complication:2 cases have the postoperation hemorrhage(13.33%),one of them is accompanied with a fever.There is no other complication.CONCLUSION:1.The therapeutic method of intra-tumor ablation surgery to treat hemangioma in pharynx with Ho:YAG Laser is a safe,efficiency therapeutic technique and easy for surgeons to operate.2.It utmostly remains normal anatomic form and function,especially suits for pharyngeal hemangiomas.