A Case Report of Endotracheal Granulation Treated by Polypectomy Snare and KTP Laser

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  • Asai Masatsugu
    Department of Otolaryngology, Toyama Medical and Pharmaceutical University
  • Abe Hideki
    Department of Otolaryngology, Toyama Medical and Pharmaceutical University
  • Wada Rinnosuke
    Department of Otolaryngology, Toyama Medical and Pharmaceutical University
  • Ishikawa Aki
    Department of Otolaryngology, Toyama Medical and Pharmaceutical University
  • Watanabe Yukio
    Department of Otolaryngology, Toyama Medical and Pharmaceutical University
  • Doki Yoshinori
    First Department of Surgery, Toyama Medical and Pharmaceutical University

Bibliographic Information

Other Title
  • 気管内肉芽治療にポリペクトミースネアとＫＴＰレーザーを用いた１例
  • 症例報告 気管内肉芽治療にポリペクトミースネアとKTPレーザーを用いた1例
  • ショウレイ ホウコク キカンナイ ニクガ チリョウ ニ ポリペクトミースネア ト KTP レーザー オ モチイタ 1レイ

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We report a 13-year-old girl suffering from dyspnea caused by a large endotracheal fleshy granulation that developed after endotracheal intubation. Treatment was considered difficult because of the following conditions : the child's endotracheal cavity was narrower than that of adults ; narrowing of the anteroposterior tracheal diameter was observed as the sequela of tracheomalacia ; the fleshy granulation comprised approximately 50% of the trachea. Therefore, for surgery, we mainly used a polypectomy snare to facilitate resection of a large amount of the fleshy granulation, and supplementarily used KTP laser. To prevent ventilation disorder during surgery, resection was performed via two routes : an oral intubation tube measuring 6 mm in inner diameter, and a tracheotomy pore. The oral intubation tube was connected to an anesthetic instrument. A fiberscope and the polypectomy snare were fixed with tape and were inserted into the trachea through the intubation tube. Forceps for nasal surgery were inserted via the tracheotomy pore to hold the granulation through the loop of the snare, and the lesion was extirpated after cauterization and resection. Additionally, the residual granulation was vaporized with the KTP laser. The present case suggested the usefulness of a combination of polypectomy snare and KTP laser in resecting fleshy granulations. However, these instruments should be used cautiously to avoid complications such as burning.

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