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coblation: An Alternative to CO2 Laser and Microdebrider for Laryngeal Papillomatosis

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International Journal of Otolaryngology and Head & Neck Surgery 2018年第2期7卷 47-54页

作者： Dasari Samuel Deenadayal Nabeelah Naeem Vyshanavi Bommakanti Dr. Deenadayal’s ENT Care Centre Secunderabad India

Objective: To assess the efficacy of coblation in treating laryngeal papillomatosis and its effect on post operative voice outcome. Study Design: This is a retrospective study. Setting: Tertiary referral centre. Subjects and Methods: All the patients diagnosed with laryngeal papillomatosis between January 2013 to December 2016 were included in this study. Preoperative assessment was done with rigid and flexible laryngoscopy. PRAAT software was used for voice analysis. All patients underwent coblation assisted microlaryngeal surgery. Post operatively patients were followed up at 1 week, 15 days, 1 month, 3 months and 6 months with rigid laryngoscopy. Voice analysis was repeated after 3 months to assess the improvement in voice. Results: coblation was found to be effective in treating laryngeal papillomatosis. In our series of seven patients, three patients underwent repeat procedure with coblation for recurrence. But longterm follow up these patients did not reveal any recurrence of laryngeal papillomatosis. Voice analysis revealed a significant improvement in measures of perturbation and maximum phonation time. Conclusion: coblation is a promising alternative to the conventional methods for the treatment of laryngeal papillomas as it can achieve satisfactory disease clearance with good voice quality.

关键词： coblation Microlaryngeal Surgery Laryngeal Papillomatosis JORRP Recurrent Respiratory Papillomatosis Laser Microdebrider

coblation Intracapsular Tonsillectomy and coblation Complete Tonsillectomy for Obstructive Sleep Apnea

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第5期4卷 350-355页

作者： Itzhak Braverman Alex Nemirovsky Adi Klein Miriam Sarid Galit Avior Unit of Otolaryngology-Head & Neck Surgery Hadera Israel Pediatric Department Hillel Yaffe Medical Center Hadera and The Faculty of Medicine The Technion Haifa Israel Western Galilee College Acco Israel

Objective: Total tonsillectomy and intracapsular tonsillectomy are common procedures for the treatment of obstructive sleep apnea (OSA) in children. The objective of this study was to compare the effectiveness of coblation intracapsular tonsillectomy (ICT) and coblation complete tonsillectomy (CT) as treatments for OSA. Study design: A retrospective study of all the children ages 2 - 18 years with OSA who underwent coblation intracapsular tonsillectomy (ICT) or coblation complete tonsillectomy (CT) from January 2007 to August 2010 by the same surgeons at one institution. Methods: Data were retrieved from children’s charts and from telephone interviews with children’s parents, regarding pre and postoperative OSA-18 scores, postoperative pain, postoperative complications, use of analgesic drugs, and time to return to a solid food diet. Results: All 43 children who underwent ICT and 37 children who underwent CT suffered from OSA before surgery, and none did postoperatively. There were no minor complications in the ICT group, compared to 13.5% in the CT group (p = 0.01). According to parental report, 72% and 21% suffered a low level of postoperative pain, and 9% and 33% severe pain in the ICT and CT groups, respectively. For these respective groups, 49% and 73% needed analgesic drugs (p < 0.05);and 65% and 35% ate solid food during the first 3 days post surgery. Conclusions: Both ICT and CT were safe, with few complications;however recovery was faster in the ICT group, as demonstrated by less pain, and more rapid return to a solid food diet.

关键词： Obstructive Sleep Apnea Tonsillectomy coblation Intracapsular Tonsillectomy Pain Adenotonsillectomy Tonsillotomy

Postoperative Outcomes in coblation versus Electrocautery Tonsillectomies

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International Journal of Otolaryngology and Head & Neck Surgery 2014年第1期3卷 32-41页

作者： Viet Pham Nikunj Rana Michael Underbrink Farrah Siddiqui Shraddha Mukerji Harold Pine Department of Otolaryngology The University of Texas Medical Branch in Galveston Galveston USA School of Medicine The University of Texas Medical Branch in Galveston Galveston USA

Purpose: To investigate whether children undergoing a tonsillectomy or adenotonsillectomy (AT) with coblation? will experience less postoperative pain and return to a normal diet and a regular activity level sooner compared to the same procedure using electrocautery dissection. This may manifest less school and work missed by the child and caregiver, respectively. Materials and Methods: Seventy-four children between the ages 2-13 years with either obstructive sleep apnea or chronic tonsillitis were recruited at a single tertiary-care center from January 2011 to November 2012 and underwent an AT via electrocautery or coblation?. Caregivers were given a ten-point Wong-Baker FACES pain scale and questions inquiring the degree of oral intake, activity level, and impact on both the child and caregiver in regards to missing work or school on postoperative days (POD) 0, 1, 2, 3, 5, 7, and 14. Results: Children in the coblation? arm required less pain medications (p 0.0049) on POD 0. Subsequent results were not significantly different for any other day. Age- and gendered-controlled multivariate analysis revealed a statistically significant difference in pain medications administered (p 0.0001) but not pain scores (p 0.2115) between the two techniques, although this difference in medications is likely related to the results observed on POD 0. There was no incidence of postoperative hemorrhage in either group. Conclusions: While there was less pain medication administered and slightly improved oral intake of liquids on POD 0 for children in the coblation? arm, there was no difference in subsequent postoperative outcome or hemorrhage rates.

关键词： Postoperative Outcomes coblation Electrocautery Tonsillectomies Pediatric

Comparison of coblation Tonsillectomy vs Dissection Tonsillectomy

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第1期8卷 49-60页

作者： Vivek Sasindran Nidhi Mathew A. K. Shabna B. Harikrishan Pushpagiri Institute of Medical Science and Research Centre Thiruvalla India

Background: Tonsillectomy is one of the most commonly performed surgical operations in the recent years. It is mainly done for chronic tonsillitis and obstructive symptoms. Aims & Objectives: To compare the operating time, intraoperative blood loss, postoperative pain, time needed to return to normal diet and activity in coblation and dissection tonsillectomy. Methods: This is a prospective study done at Pushpagiri Medical College for a period of one and a half years from March 2015 to September 2016. Out of the 50 patients, 25 underwent coblation tonsillectomy and 25 underwent conventional dissection tonsillectomy. Method of surgery depended on patients’ or parents’ choice. Intra operative measures like operating time, blood loss and post-operative morbidity were measured and compared. Results: In this study, there was significant difference in intraoperative time in coblation tonsillectomy compared to cold dissection tonsillectomy (mean operative time—13.4 minutes for coblation and 20.4 minutes for cold dissection with p value less than 0.05). Intraoperative blood loss was significantly less for coblation (18.9 ml) compared to traditional (43.0 ml) with p value 0.002. Average postoperative pain score 6 hours after operation was 7.6 for coblation and 8.5 for cold dissection with a significant p value of 0.002. Average time taken to return to normal diet among coblation was 6.4 days and dissection was 7.0 days with p value of 0.078 which is not statistically significant. However, average time taken to return to normal activity among coblation was 6.3 days and dissection was 7.1 days with a significant p value of 0.024. Conclusion: coblation tonsillectomy significantly reduces the operation time, intraoperative blood loss, immediate postoperative pain, and patient returns early to regular routine, but with a higher cost.

关键词： Tonsillectomy Cold Dissection coblation Operation Time Postoperative Pain

A New Modality of Treatment for Adult Laryngeal Haemangioma by coblation: A Case Report

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International Journal of Otolaryngology and Head & Neck Surgery 2017年第3期6卷 23-27页

作者： Dasari Samuel Deenadayal Bashetty Naveen Kumar Dumpala Vidyasagar T. Praveen Department of ENT Head and Neck Yashoda Hospital Secunderabad Telangana India

Few adult haemangiomas of larynx have been reported. Most common presentations are in infants where the incidence is about 4% - 5% [1]. In children they resolve by age of five whereas in adults they do not regress. In children the most common modality of treatment is by propranolol. In adults, there are various modalities of surgical excision by laser excision with Co2 or KTP and electrocautery assisted excision. We are presenting a case of adult laryngeal haemangioma that presented with blood-tinged sputum on coughing since 8 months and we managed with micro laryngeal surgical excision by coblation without any complications.

关键词： coblation Laryngeal Haemangioma Propranolol

Microscopic Surgery with coblation for the Treatment of Benign Laryngeal Lesions: A Case Report

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International Journal of Otolaryngology and Head & Neck Surgery 2016年第3期5卷 125-128页

作者： Anant Chouhan Mohan Kulhari B. Amisha Neeraj Kasliwal Department of ENT Fortis Hospital Jaipur India

Background: coblation based bipolar plasma devices are designed to operate at a relatively low temperature to gently dissolve and/or shrink target tissue with minimal thermal damage to surrounding healthy tissue. coblation technology provides ablation, resection, coagulation of soft tissue and hemostasis of blood vessels in one convenient surgical device. coblation technology can be used in the larynx and trachea for removing or debulking sessile polyps, lesions or tumors. Minimally invasive coblation technology can offer less invasive treatment with quicker recovery and shorter hospitalization. Aim: This case study aims to explore the advantages of coblation combined with microscopy to treat benign laryngeal lesions. Case report: We report the case of laryngeal papilloma treated with minimally invasive coblation resection. Fiberoptic laryngoscopy was done pre-operatively and that showed papillomatous mass at anterior half of right vocal cord involving inferior surface and also extending upto anterior commissure. Mobility of both vocal cords was normal. On the basis of the above findings with normal vocal cords mobility, the microlaryngeal surgery with coblation was planned. After complete pre-op work up, the patient underwent trans-oral microscopic coblation excision of mass under general anaesthesia. Power level was set to 7 for ablation and 3 for coagulation. The PROciseTM LW Plasma Wand system was chosen such that it was malleable to reach the papillomatous mass without obstructing the vision. It was totally excised and sent for histopathology examination. Post-operatively after four hours, he was able to take normal diet comfortably. He was followed up after 10 days. Histopathological report confirmed the diagnosis of papilloma. Check laryngoscopy was performed after 3 weeks. Laryngeal examination was absolutely normal with almost normal vocal cords and normal voice post-operatively. Conclusion: Microscopic surgery with coblation has the advantages o

关键词： Hoarseness Papilloma Larynx coblation Microlaryngeal Surgery

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胸椎前路松解术

中华临床医学杂志 2007年第2期8卷 42-46页

作者：张如意张永刚辽宁医学院骨科学 121001

胸椎前路松解手术应用于脊柱侧凸的治疗已有近半个世纪，对于先天性侧凸、特发性侧凸年龄过小，为防止曲轴现象所作的前路松解目的明确，且效果肯定。而对于重度、僵硬性脊柱侧凸，通过一期前路松解，同期或者二期联合后路松解内固定融... 详细信息

胸椎前路松解手术应用于脊柱侧凸的治疗已有近半个世纪，对于先天性侧凸、特发性侧凸年龄过小，为防止曲轴现象所作的前路松解目的明确，且效果肯定。而对于重度、僵硬性脊柱侧凸，通过一期前路松解，同期或者二期联合后路松解内固定融合术明显增加了手术的矫正率，并减少了并发症的发生。脊柱侧凸的主弯以胸弯最为多见，所以胸椎前路松解术在脊柱畸形，尤其是严重、僵硬脊柱畸形的矫形术中的作用突显重要。故了解胸椎前路松解术的发展、适应证、手术方法、生物力学以及并发症的防治也具有重要意义。

关键词：前路松解脊柱侧凸胸腔镜 coblation