Clinical analysis of microdebrider removal of recurrent respiratory papilloma: A report of 33 cases

Abstract

OBJECTIVE To investigate the advantages of applying microdebrider removal of juvenile-onset recurrent respiratory papillary epithelioma (JO-RRP), using an endoscopy-assisted prop-up laryngoscope. METHODS The degree of severity of the neoplasms was divided into 3 scores (i.e. 1 point for a slight degree, 2 points for a moderate and 3 points for a severe degree). The involvement of 22 respiratory and digestive sub-areas was evaluated and the total accumulative scoring and the scores for the lesions in the vocal area were calculated and sub-grouped. All the papillary epitheliomas were excised using a laryngeal micro-debrider or the micro laryngeal forceps under endoscopy-assisted suspension laryngoscopy. The differences between applications of the two modes of treatment for the cases of the groups with same scoring were compared as follows: the operation time, interval of operation, recent vocal quality after operation, postoperative scarring and incision of the trachea, as well as the distribution of tumors in a re-operation. RESULTS The 142 operative procedures were performed in 33 pediatric patients, with application of a laryngeal microdebrider in 14 cases and excision in 19. Compared to the excision group (EG), the laryngeal microdebrider group (MDG) displayed many superior features, such as a short operation time, long interval between operations, obvious improvement in vocal quality soon after operation, and a low frequency of subsequent tumors. There was a significant difference between these modes of the operation. A postoperative incision of the trachea was required in 2 cases of EG, whereas no post-operation was needed in the MDG. CONCLUSION There are many advantages in using laryngeal micro-debrider removal of JO-RRP. The procedure is simple and convenient, having a distinct operating field, precise incision, minor wounds, fewer complications and better vocal quality soon after operation, as well as quicker rehabilitation and longer intervals between operations, etc.