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Microdebrider Versus CO 2 Laser Removal of Recurrent Respiratory Papillomas: A Prospective Analysis
Author(s) -
Pasquale Kimberly,
Wiatrak Brian,
Woolley Audie,
Lewis Linda
Publication year - 2003
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200301000-00026
Subject(s) - medicine , surgery , prospective cohort study , respiratory system , anesthesia
Objective To compare postoperative patient discomfort, voice quality, and procedure time and cost for removal of recurrent respiratory papillomas using the microdebrider versus the CO 2 laser. Study Design A randomized prospective study comparing children undergoing excision of recurrent respiratory papillomas by CO 2 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 CO 2 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 CO 2 laser for removal of recurrent respiratory papillomas.