Optimal positioning techniques with fiberoptic laser excision in the treatment of congenital tongue base lesions.

INTRODUCTION Congenital midline lingual lesions are rare complex problems in the pediatric population, causing issues ranging from feeding difficulty to life-threatening airway obstruction. Treatment options generally include excision or marsupialization. Due to the size and configuration of the neonatal pharynx, resections of tongue base masses present a unique surgical challenge. The method of positioning and retractor type and placement are critical for visualization. For the actual resection, a flexible fiberoptic laser is ideal for minimizing blood loss for a clear operative field and to allow access around corners and in tight spaces. Previous descriptions of laser techniques have been limited to the CO2 laser, 1,2 and to our knowledge there have not been detailed discussions of ideal positioning. We describe three cases in which Holmium-YAG and KTP lasers were employed via different visualization techniques for excision of such lesions.