Title : Refining the role of Coblation technology in the larynx
Abstract:
Coblation technology offers the ability to ablate or remove soft tissue and cartilage from the larynx through the creation of a low temperature plasma field. Surrounding thermal injury is minimal but achieving precision can be a challenge. Given the delicate layered microstructure of the vocal folds, new tehcnology needs to be used with caution to avoid irreversible injury and permanent hoarseness. With a number of years fine tuning the application of this technology byt the author, helpful guidelines have been established to maximise afficacy and safety in treating laryngeal pathology
Methodology: Consectuive patients presenting to a single surgeon from July 2013 to June 2018 with varying laryngeal pathology were included. All patients had pre and post-surgery high-definition videostroboscopy and voice handicap index (VHI) scores recorded. Minimum patient follow-up was 4 months. Outcome measures were disease resolution, recurrence, revision surgery, changes in the VHI and post-surgery videostroboscopy. Conditions treated included vocal process granuloma, false cord resection, debulking of papilloma, stenosis resection, suture lateralisation and other laryngeal granulation.
Results: Fifty five patients were included, complete data was available on 52 patients. (final results pending). The VHI was elevated pre-surgery and lowered in some post-surgery(results pending). There were two recurrences The use of Bioglue as a novel technique improved outcomes.
Conclusion: Careful application of Coblation technology in the larynx provides safety and efficacy on treatment certain laryngeal pathology. The techniques are relatively simple to acquire and the technology is reliable in reproducing results. Awareness of the delicate layered microstructure of the vocal folds and the possibility of irreversible damage and hoarseness should always guide application of new technology to maximize outcomes.
