Harmonic Scalpel in the Treatment of Snoring

Abstract

Objective: The Ultracision Harmonic Scalpel (HS) is an ultrasonic cutting and coagulating surgical device. The mechanism of the HS is based on transforming electrical energy into mechanical movement of 55.5 kHz frequency. This work aims to report our 4 years’ experience with HS in the treatment of snoring (uvulopalatopharyngoplasty). Method: Specific handpieces shaped like hook and blade were preferred. After tonsillectomy, 2 incisions, were made on each side of the lateral margin of the uvula, with upward direction. Thereafter, an excision of the redundant mucosa of each posterior arch and subsequent creation of neouvula by a partial uvulectomy was done. Results: In all the patients treated, the HS allowed rapid intraoperative management with a precise and safe cut: the HS provided excellent control without side effects on the adjacent structures and postoperative complications. Compared with other techniques (laser, cold knife dissection, etc) HS’s group experienced shorter operation time, lesser blood loss, fewer days of hospitalization, lower postoperative pain, and improvement of voice quality. No complications with regard to hemostasis or other major complication (temporary velopharyngeal insufficiency, bleeding, globus sensation, etc) were noted in the HS group. Conclusion: Our experience highlights that the use of HS in uvulopalatopharyngoplasty confers some advantages over conventional methods: its use led to diminished bleeding, shorter operation time, lesser pain, better wound healing in the postoperative period, and reduction of snoring and improvement of voice quality.