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Microdement

  • William LunnEmail author
Chapter

Abstract

While obstruction of the central airways usually occurs over time, patients so affected often require relief on an urgent or semiurgent basis. Physicians have many tools at their disposal, but none can match the microdebrider for its combination of rapid tissue removal and precision.

The microdebrider is a simple instrument: a spinning blade mounted on a hollow tube coupled to suction. It allows the surgeon to remove tissue in a precise manner, avoiding damage to surrounding structures and limiting the need for thermal modalities. Orthopedic surgeons and otolaryngologists have employed microdebriders for years. Thoracic surgeons and interventional pulmonologists have discovered microdebridement more recently, gaining experience in airway interventions over the last 5 years. Physicians have described its use in managing airway granulation tissue, removing foreign bodies, debriding papillomas, and removing malignant tissue.

As investigators have gained more experience with microdebridement, studies have been completed to compare standard operations in the upper respiratory tract done with microdebridement to more traditional techniques. Microdebridement for airway interventions has grown out of its infancy. Though not without limitations, it is a very useful modality for physicians well versed in suspension laryngoscopy and rigid bronchoscopy.

Keywords

Airway Wall Argon Plasma Coagulation Acoustic Neuroma Airway Intervention Yttrium Aluminum Garnet Laser 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. 1.
    Mirante J, Christmas D, Yanagisawa E. History and development of powered instrumentation in otolaryngology, head, and neck surgery. In: Yanagisawa E, Christmas D, Mirante J, editors. Powered Instrumentation in otolaryngology, head, and neck surgery. 1st ed. San Diego: Singular; 2002. p. 1–4.Google Scholar
  2. 2.
    Simoni P, Peters GE, Magnuson JS, et al. Use of the endoscopic microdebrider in the management of airway obstruction from laryngotracheal carcinoma. Ann Otol Rhinol Laryngol. 2003;112(1):11–3.PubMedGoogle Scholar
  3. 3.
    Lunn W, Garland R, Ashiku S, et al. Microdebrider bronchoscopy: a new tool for the interventional bronchoscopist. Ann Thorac Surg. 2005;80:1485–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Wahidi M, Herth F, Ernst A. State of the art: interventional pulmonology. Chest. 2007;131(1):261–74.PubMedCrossRefGoogle Scholar
  5. 5.
    Kennedy M, Morice R, Jimenez C, et al. Treatment of bronchial airway obstruction using a rotating tip microdebrider: a case report. J Cardiothorac Surg. 2007;2:16.PubMedCrossRefGoogle Scholar
  6. 6.
    Lunn W, Bagherzadegan N, Munjampalli S, et al. Initial experience with a rotating airway microdebrider. J Bronchol. 2008;15(2):91–4.CrossRefGoogle Scholar
  7. 7.
    Nuyens M, Zbären P, Seifert E. Endoscopic resection of laryngeal and tracheal lesions using the microdebrider. Laryngoscope. 2009;119(1):162–70.CrossRefGoogle Scholar
  8. 8.
    Guerrero J, Majid A, Ernst A. Cardiogenic shock secondary to tako-tsubo syndrome after debridement of malignant endobronchial obstruction. Chest. 2009;135(1):217–20.PubMedCrossRefGoogle Scholar
  9. 9.
    Holler T, Allegro J, Chadha N, et al. Voice outcomes following repeated surgical resection of laryngeal papillomata in children. Otolaryngol Head Neck Surg. 2009;141(4):522–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Wilson Y, Merer D, Moscatello A. Comparison of three common tonsillectomy techniques: a prospective randomized, double-blinded clinical study. Acta Otolaryngol. 2006;126(4):402–7.CrossRefGoogle Scholar
  11. 11.
    Gallagher T, Wilcox L, McGuire E, et al. Analyzing factors associated with major complications after adenotonsillectomy in 4776 patients: comparing three tonsillectomy techniques. Otolaryngol Head Neck Surg. 2010;142(6):886–92.PubMedCrossRefGoogle Scholar
  12. 12.
    Lee D, Kim E. Microdebrider-assisted versus laser-assisted turbinate reduction: comparison of improvement in nasal airway according to type of turbinate hypertrophy. Ear Nose Throat J. 2010;89(11):541–5.PubMedGoogle Scholar
  13. 13.
    Cingi C, Ure B, Cakli H, et al. Microdebrider-assisted versus radiofrequency-assisted inferior turbinoplasty: a prospective study with objective and subjective outcome measures. Acta Otorhinolaryngol Ital. 2010;30(3):138–43.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Christus Health Northern LouisianaChristus Schumpert Health SystemShreveportUSA

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