L Calero1, T Brusis. 1. Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie der Kliniken der Stadt Köln, Krankenhaus Köln-Holweide. calerol@kliniken-koeln.de
Abstract
BACKGROUND: The CO (2)-Laser is an established and well-proven tool in the excision and vaporisation of laryngeal papillomatosis. Actually there exists only one report of an iatrogenous infection with the Human Papillomavirs (HPV) in a gynecological laser surgeon. CASE REPORT: A 28-year-old gynecological operating room nurse, who assisted repeatedly in electrosurgical and lasersurgical excisions of anogenital condylomas, developed a recurrent and histologically proven laryngeal papillomatosis. The expert opinion of a virological institute confirmed a high probability of correlation between the occupational exposition and the laryngeal papillomatosis so that it was accepted as occupational disease. INFECTIVITY OF LASER PLUME: HPV-DNA has been repeatedly detected in laser-plume after excision of papillomas and condylomas. As of the present an exact proof that these particles are infectious has not been brought forward. CONCLUSION: When following the recommended protective measures the potential risk of infection is estimated as very low for surgeons and nurses. The risk of exposition seems to be higher in gynecological interventions than in ENT because of the much larger tissue masses and because laser plume escapes easier into the room air when applying an open approach.
BACKGROUND: The CO (2)-Laser is an established and well-proven tool in the excision and vaporisation of laryngeal papillomatosis. Actually there exists only one report of an iatrogenous infection with the Human Papillomavirs (HPV) in a gynecological laser surgeon. CASE REPORT: A 28-year-old gynecological operating room nurse, who assisted repeatedly in electrosurgical and lasersurgical excisions of anogenital condylomas, developed a recurrent and histologically proven laryngeal papillomatosis. The expert opinion of a virological institute confirmed a high probability of correlation between the occupational exposition and the laryngeal papillomatosis so that it was accepted as occupational disease. INFECTIVITY OF LASER PLUME: HPV-DNA has been repeatedly detected in laser-plume after excision of papillomas and condylomas. As of the present an exact proof that these particles are infectious has not been brought forward. CONCLUSION: When following the recommended protective measures the potential risk of infection is estimated as very low for surgeons and nurses. The risk of exposition seems to be higher in gynecological interventions than in ENT because of the much larger tissue masses and because laser plume escapes easier into the room air when applying an open approach.
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