title: Microdebrider versus CO2 laser removal of recurrent respiratory papillomas: a prospective analysis.
abstract: OBJECTIVE
  To compare postoperative patient discomfort, voice quality, and procedure time and cost for removal of recurrent respiratory papillomas using the microdebrider versus the CO2 laser.
  
  
  METHODS
  A randomized prospective study comparing children undergoing excision of recurrent respiratory papillomas by CO2 laser versus excision by microdebrider.
  
  
  METHODS
  For the 6-month study, patients for whom removal of recurrent respiratory papillomas was indicated were randomly assigned by birth year to microdebrider or CO2 laser therapy. Disease severity was scored as the sum of ratings of 1+ (minimal), 2+ (moderate), or 3+ (severe) for involvement of 27 areas of the aerodigestive tract by direct microlaryngoscopy immediately before treatment. Parents scored patient discomfort and improvement in voice quality 24 hours after surgery, using a 5-point (0 = no pain; 4 = worst pain) and a 10-point (1 = minimal change; 10 = significant improvement) scale, respectively.
  
  
  RESULTS
  Nineteen patients ranging in age from 2.5 to 20 years underwent 32 procedures in all. Groups did not differ significantly in age, sex, or severity of disease. For disease of equivalent severity, microdebrider treatment was associated with equivalent 24-hour-postoperative pain scores, greater improvement in voice quality, shorter procedure times, and lower overall procedure cost.
  
  
  CONCLUSIONS
  Immediate postoperative results indicate that the microdebrider may be as safe as and, at some institutions, might be more cost-effective than the CO2 laser for removal of recurrent respiratory papillomas.
authors.affiliation: Division of Otolaryngology--Head and Neck Surgery, The University of Alabama at Birmingham, USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Pasquale
authors.forename: Brian
authors.initials: B
authors.lastname: Wiatrak
authors.forename: Audie
authors.initials: A
authors.lastname: Woolley
authors.forename: Linda
authors.initials: L
authors.lastname: Lewis
mesh_terms: D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D002245:Carbon Dioxide; D002648:Child; D002675:Child, Preschool; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms; D007828:Laryngoscopy; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010212:Papilloma / Q000175:diagnosis / Q000601:surgery*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014134:Tracheal Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide