Abstract
The recent use of powered microdebriders in laryngeal surgery has significantly altered the surgical management of supraglottic lesions. We have successfully used these microresectors to treat more than 40 pediatric patients with respiratory papillomas, vocal cord lesions, or vallecular disease. Before positioning the patient with the Lewy suspension system (Pilling, Fort Washington, PA), direct laryngoscopy and bronchoscopy are often performed. This enables determination of the extent of disease and identification of important landmarks before operative intervention. Once the patient is properly suspended and the larynx is adequately visualized, the operating microscope may be positioned, allowing the lesion to be thoroughly resected under direct visualization. Some advantages this technique offers over the use of CO<sub>2</sub> laser include (1) greater flexibility in selection of anesthesia/ventilation; (2) lower risk of thermal injury to the larynx; and (3) lower intraoperative personnel and equipment expenses.
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