.png)
Objectives: Large benign cysts and cyst-like lesions of the pharynx and larynx are rare and difficult to suspect because of the non-specific nature of the symptoms. Not infrequently it is an accidental finding during esophagogastroduodenoscopy or medical imaging. From a surgical standpoint, these lesions are also challenging, especially if endoscopic removal is selected. The objectives were to evaluate the efficacy and safety of endoscopic laser removal of large benign pharyngolaryngeal lesions.
Methods: This study was a case series with chart review. We performed retrospective analysis of patients with large benign pharyngolaryngeal lesions, who underwent surgery at the ENT Department of Pavlov First Saint Petersburg State Medical University (Russia) between 2010 and 2017.
Results: Six patients with large benign pharyngolaryngeal lesions (two lipomas, two cysts, one leiomyoma, and one neurofibroma) had surgery, which was done under general anesthesia via direct microlaryngoscopy. A near-infrared diode laser was used as a surgical tool in all cases, and laryngeal shaver was used in two cases. A high-frequency jet ventilation via thin catheter provided a completely unobscured operative field. Despite the bulkiness of the lesions, there were no airway complications during anesthesia or after surgery. The post-operative period was uneventful in all cases.
Conclusions: Bulky benign pharyngolaryngeal lesions can be safely and completely removed via an endoscopic approach without prior tracheostomy. An experienced laryngeal surgeon and anesthesiologist, who are familiar with jet ventilation technique, are important for a favorable outcome. The diode laser is a convenient instrument for such surgery, allowing almost bloodless tumor dissection. Level of Evidence: 4.