Microdebrider bronchoscopy: a new tool for the interventional bronchoscopist.
OBJECTIVE
We report our experience with a new airway tool, the microdebrider, in treating central airway obstruction.


METHODS
From April 2002 to April 2004, 23 patients undergoing treatment of central airway obstruction were managed with the microdebrider. All procedures were done under general anesthesia with either a rigid bronchoscope (19 patients) or a suspension laryngoscope (4 patients). The microdebrider was used in an oscillating mode with rotation speeds of 1,000 to 3,000 rpm to resect obstructing tissue.


RESULTS
Fourteen patients (61%) had tracheal granulation tissue from prior intubation or tracheostomy, 6 (26%) had idiopathic subglottic stenosis, and 3 (26%) had malignant disease. Obstructing lesions were rapidly removed in all patients with interventions lasting between 2 and 15 minutes. There were no procedure-related complications. No patients required reoperation for airway obstruction in follow-up ranging from 1 to 24 months.


CONCLUSIONS
Microdebrider bronchoscopy is a new technique that allows for precise, rapid, and safe removal of lesions obstructing the central airways. Complications of thermal modalities such as airway injury, tracheoesophageal fistulas, and airway fires can be avoided.
Lunn
William
W
Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Garland
Robert
R
Ashiku
Simon
S
Thurer
Robert L
RL
Feller-Kopman
David
D
Ernst
Armin
A
D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000601:surgery*; D001999:Bronchoscopy / Q000379:methods*; D003646:Debridement / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome