• Wenyang Wang, Zhirui Zhu, Wenlong He, Yaoqin Hu, and Qiao Zeng.
• Department of Anesthesiology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
• Medicine (Baltimore). 2023 Jun 2; 102 (22): e33949e33949.

RationaleRecurrent laryngeal papillomatosis (RLP) is a common benign tumor in the larynx of children, which is characterized by high recurrence rate and rapid growth, leading to clinical symptoms such as hoarseness and difficulty breathing. Low-temperature plasma radiofrequency ablation (RFA) is the main treatment, but ventilation problems are often encountered during surgery.Patient ConcernsWe report a case of a 2-year-old child with RLP who underwent low-temperature plasma RFA with the assistance of a laryngoscope. However, the surgery had to be temporarily stopped due to ventilation difficulties and difficulty in maintaining blood oxygen saturation during the procedure.DiagnosisThe child was diagnosed with RLP.InterventionsThe child underwent low-temperature plasma RFA supported by laryngoscopy assisted by ECMO.OutcomesDespite ventilation problems during surgery, the use of ECMO support helped maintain good oxygen saturation in the child and provided a clear surgical field, enabling the tumor to be quickly and cleanly removed. Therefore, the use of ECMO provided critical support during the surgery.LessonsThis case highlights the importance of airway management during laryngeal papillomatosis surgery. A thorough airway assessment should be performed before anesthesia, and early use of ECMO can reduce harm to the child and ensure the child's safety.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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