- The ability to rapidly remove obstructing tissue.
- The ability to simultaneously remove tissue debris and blood allowing for better visualization of the field.
- The ability to precisely limit the effects of the modality without fear of combustion or perforation of the airway.
Another advantage cited by Dr. Lunn is that the rigidity of the tool allows for a tactile feel of the airway wall. It is possible to simply stop the rotation of the blade and use the blade to touch and feel the airway, something that can’t be done with the filament of a laser.
Explore This IssueFebruary 2007
When asked if there are cases of airway obstruction in which use of the microdebrider might be contraindicated, Dr. Lunn responded, No. There’s really nothing. If I need to remove the tissue anyway, I think the debrider is the most delicate way to do it.
Tonsillectomies are performed on more than 300,000 patients annually in the United States, primarily for chronic obstruction or infection. In traditional tonsillectomy, the removal of the capsule enclosing the tonsil leaves the throat muscles, large blood vessels, and nerves exposed. Bleeding is generally controlled by electrocautery. This process leaves the patient with severe pain and swelling, frequently requiring the patient to take pain medications for several days. This pain and swelling can also lead to decreased oral intake, causing dehydration that may in some cases even require further hospitalization. These effects can significantly delay the patient’s return to normal activity.
In a study published in Otolaryngology-Head and Neck Surgery in January 2005, researchers concluded that use of a microdebrider for partial tonsillectomy resulted in less pain for patients and shorter recovery times. The study, supported by an unrestricted grant from Medtronic, introduced the powered intracapsular tonsillectomy and adenoidectomy (PITA) technique utilizing a microdebrider tool. Using this technique, physicians removed 90% to 95% of the tonsils, leaving the capsule in place to protect the throat muscles, blood vessels, and nerves.
In this study, patients’ caretakers were asked to record pain levels, doses of pain medications, time of return to normal activity, and time of return to normal diet following tonsillectomy. Patients who had partial tonsillectomy utilizing the microdebrider were three times more likely to not require pain medicine three days following surgery, and almost twice as likely to have resumed normal activity levels than patients receiving traditional tonsillectomy.4
Sinusitis can have a significant impact on quality of life and is an extremely common health problem in the United States. An estimated 37 million Americans suffer sinusitis attacks lasting for at least 12 weeks or recurring frequently. Although most individuals who suffer from sinusitis can be treated with medications, about 10% of sufferers require surgery to obtain relief. Sinus surgery has a long-standing reputation of being especially brutal for patients, requiring external incisions and nasal packing, and leaving patients with pain and bruising for weeks following the procedure. Use of the endoscope has made sinus surgery much less traumatic, eliminating the need for external incisions. Use of the microdebrider can allow for even more delicate tissue removal, reducing the need for separate grasping and cutting instruments.5