TITLE:
Microscopic Surgery with Coblation for the Treatment of Benign Laryngeal Lesions: A Case Report
AUTHORS:
Anant Chouhan, Mohan Kulhari, B. Amisha, Neeraj Kasliwal
KEYWORDS:
Hoarseness, Papilloma Larynx, Coblation, Microlaryngeal Surgery
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.5 No.3,
May
13,
2016
ABSTRACT: Background: Coblation based bipolar
plasma devices are designed to operate at a relatively low temperature to
gently dissolve and/or shrink target tissue with minimal thermal damage to surrounding healthy tissue. Coblation technology
provides ablation, resection, coagulation of soft tissue and hemostasis
of blood vessels in one convenient surgical device. Coblation technology can be
used in the larynx and trachea for removing or debulking sessile polyps,
lesions or tumors. Minimally invasive
coblation technology can offer less invasive treatment with quicker recovery
and shorter hospitalization. Aim:
This case study aims to explore the advantages of coblation combined with microscopy to treat benign laryngeal lesions. Case report: We
report the case of laryngeal papilloma treated with minimally invasive
coblation resection. Fiberoptic laryngoscopy was done pre-operatively and that
showed papillomatous mass at anterior half of right vocal cord involving
inferior surface and also extending upto anterior commissure. Mobility of both
vocal cords was normal. On the basis of the
above findings with normal vocal cords mobility, the microlaryngeal surgery with coblation was planned. After complete pre-op work up, the patient underwent
trans-oral microscopic coblation excision of mass under general anaesthesia.
Power level was set to 7 for ablation and 3 for coagulation. The PROciseTM LW Plasma Wand system was chosen such that it was malleable to reach the
papillomatous mass without obstructing the vision. It was totally excised and
sent for histopathology examination. Post-operatively after four hours, he was
able to take normal diet comfortably. He was
followed up after 10 days. Histopathological report confirmed the diagnosis
of papilloma. Check laryngoscopy was performed after 3 weeks. Laryngeal
examination was absolutely normal with almost normal vocal cords and normal
voice post-operatively. Conclusion:
Microscopic surgery with coblation has the advantages of less bleeding, short
procedure duration, increased completion rate and few complications.