Endoscopic resection of laryngeal and tracheal lesions using the microdebrider.
CONCLUSIONS
Endoscopic resection of laryngeal and tracheal lesions using the microdebrider is a safe, accurate and reliable method.


OBJECTIVE
The microdebrider is an important tool for endoscopic nasal and sinus surgery and over the last few years a powered blade with a long shaft has been developed for endoscopic laryngeal and tracheal surgery. The aim of this non-randomized prospective study was to determine the advantages and disadvantages of the microdebrider for treating patients with different laryngeal and tracheal pathologies.


METHODS
The laryngeal microdebrider was used under endoscopic control in 37 patients. In 29 cases a benign laryngeal lesion was removed endoscopically. In four patients debulking of a malignant obstructive endolaryngeal tumor was performed in order to avoid a tracheotomy. In four cases a bulky obstructing endotracheal lesion was removed.


RESULTS
All laryngotracheal lesions could be removed, and this was facilitated by the use of angled rigid telescopes and the laryngeal blade. No traumatic lesions to normal laryngeal tissue occurred as a result of use of the microdebrider and no postoperative endolaryngeal bleeding was observed. The histological diagnosis of the biopsies taken with the microdebrider was accurate in every case. In three of the four cases with obstructive laryngeal malignancies, a tracheotomy was avoided until definitive therapy was undertaken. Normal breathing was restored in all patients with endotracheal lesions.
Nuyens
Michel
M
Department of Otorhinolaryngology-Head and Neck Surgery, University of Berne, Inselspital, Berne, Switzerland. michel.nuyens@insel.ch
Zbären
Peter
P
Seifert
Eberhard
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003646:Debridement / Q000295:instrumentation*; D004417:Dyspnea / Q000209:etiology; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000601:surgery*; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014133:Tracheal Diseases / Q000601:surgery*; D016896:Treatment Outcome