Expanding applications for the microdebrider in pediatric endoscopic airway surgery

Abstract

Objectives: The microdebrider has been described as a useful tool in treating laryngeal papillomas, but there are no reports in the literature of other uses for this instrument in the pediatric airway. The objective of this paper is to describe expanding applications for the microdebrider in pediatric airway surgery. Methods: All pediatric airway cases in which the microdebrider was used over a 16-month period were reviewed. The cases of laryngeal papillomas were noted, and additional previously unreported uses of the microdebrider were described. The specific utility and advantages of the microdebrider in each surgical setting were identified. Results: The microdebrider was used in 51 pediatric airway procedures. Twenty-three of these cases involved novel previously unreported applications of the microdebrider. These include distal tracheal papillomas, tracheal and subglottic stenosis, suprastomal and distal tracheal granulations, and a variety of other lesions. Specific scenarios in which the microdebrider was felt to be indispensable to the procedure are described. Conclusions: The microdebrider is an exciting and promising instrument that has previously only been described for treatment of laryngeal papillomas in pediatric patients. However, we have found that correct utilization of the various tip configurations available on this instrument have made management of many airway lesions commonly encountered by pediatric otolaryngologists safer, more expedient, cheaper, and simpler than previously described methods. In our practice, this instrument has largely supplanted the use of the CO 2 laser and some open approaches for management of many pediatric tracheal problems.