Ultrasonic Aspirator‐Assisted Laryngeal Framework Surgery

Abstract

Objective: (1) Demonstrate the utility of the ultrasonic surgical aspirator in minimizing the risk and simplifying laryngeal framework surgery. (2) Determine the benefits using of this technique in the setting of resident education. Method: Case series using the SONOPET ultrasonic surgical aspirator (MIWATEC Co., Ltd.) to enable precise dissection of laryngeal cartilage without thermal or mechanical injury to the surrounding soft tissue or mucosa. We describe the first application of this technology in the in vivo larynx for type I thyroplasty and laryngofissure approaches. Results: Laryngeal framework surgery using current techniques have the limitations of difficulty incising calcified cartilage, mechanical chatter, thermal injury, and soft tissue damage. The ultrasonic surgical aspirator was used in four medialization thyroplasty procedures and two laryngofissure approaches for open laryngoplasty without intraoperative or postoperative complications. No infections or inadvertent soft tissue damage were observed. There were no complications of implant placement or with early healing. Finally, a very slight learning curve exists for its use in resident performed procedures and time to perform cutting tasks was faster than standard techniques. Conclusion: The ultrasonic surgical system may be used as an alternative to standard surgical technique, surgical drill, or oscillating saw for laryngeal framework surgery. Limited learning curve exists and our results indicate that the device can be used safely and in a reasonable amount of time.