Coblation removal of large suprastomal tracheal granulomas

David, Helena Maria Scherlowski Leal

doi:10.1002/lary.20035

Cited by 17 publications

(12 citation statements)

References 8 publications

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“…They were able to immediately decannulate 20% of the patients who underwent neon laser technique and 40% of the fiberoptic CO 2 laser group. Kitsko and Chi [9] described a technique using coblation to ablate SSGT, theorizing that this endoscopic technique should also decrease operative times, blood loss, and obviate the need for airway fire precautions and complicated instruments.…”

Section: Discussionmentioning

confidence: 98%

“…However, because they can cause bleeding, aphonia, and airway obstruction that can delay decannulation, and even death with accidental decannulation [3,5,6], multiple methods of excision of these lesions have been developed and described in the literature. Most SSGT can be removed endoscopically via several methods such as the hook and eversion technique, sphenoid punch, kerrison rongeur, optical forceps [1], CO 2 , Nd:YAG, KTP laser [7,8] and coblation [9]. Some severely fibrosed SSGT require open procedures involving laryngotracheofissure [1].…”

Section: Introductionmentioning

confidence: 99%

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Powered debridement of suprastomal granulation tissue to facilitate pediatric tracheotomy decannulation

Chen

Bent

Parikh

2011

International Journal of Pediatric Otorhinolaryngology

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Powered debridement of suprastomal granulation tissue to facilitate pediatric tracheotomy decannulation

Chen

Bent

Parikh

2011

International Journal of Pediatric Otorhinolaryngology

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“…The coablation has advantages including rapid and precise ablation, little thermal damage, and the integrated function of suction and coagulation [4]. Kitsko et al [5] described the technique of coblation to remove a suprastomal granuloma in a single patient. However, more data is still needed to demonstrate the potential of coblation in managing airway stenosis, with only few reports up to now.…”

Section: Discussionmentioning

confidence: 99%

Tracheotomy-coblation for acquired subglottic tracheal stenosis: a case report

Huang

Zhang

2019

J Cardiothorac Surg

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Background Tracheal stenosis caused by tracheotomy and intubation is considered intractable. Although the segmental tracheal resection and endoscopic intervention are available, they usually result in great operation injury or are difficult to perform. Case presentation A patient with acquired tracheal stenosis was treated with tracheotomy-coblation. The patient was followed up by bronchoscopy every 2 months. After 6-month follow-up, the symptoms of dyspnea and hoarseness disappeared and no tracheal stenosis was observed. Conclusions The present technique, tracheotomy-coblation, is advantageous with less injury and easy to perform.

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“…Then, the Smith and Nephew® Procise MLW or LW Coblation wand is passed endoscopically through the larynx and into the suprastomal area to ablate the granuloma under direct telescopic visualization. This completely endoscopic approach differs from the external technique that has been previously described by Kitsko et al [10]. An ablation setting of 7 and coagulation setting of 4 is used with the Smith and Nephew® Coblator II Surgery System.…”

Section: Methodsmentioning

confidence: 99%

“…Its use has also been described for microcystic lymphatic malformations [6], aerodigestive tumors [7], airway stenosis [8] and laryngeal papillomatosis [9]. In 2009 Kitsko et al initially described a technique of using coblation to remove suprastomal granulomas externally through the tracheal stoma under bronchoscopic guidance [10]. We present five cases of suprastomal granuloma that were effectively managed with a similar, but primarily endoscopic coblation technique.…”

Section: Introductionmentioning

confidence: 99%

Coblation of suprastomal granulomas in tracheostomy-dependent children

Brown

Ryan

Ramprasad

et al. 2017

International Journal of Pediatric Otorhinolaryngology

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Objective Suprastomal granulomas pose a persistent challenge for tracheostomy-dependent children. They can limit phonation, cause difficulty with tracheostomy tube changes and prevent decannulation. We describe the use of the coblator for radiofrequency plasma ablation of suprastomal granulomas in five consecutive children from September 2012 to January 2016. Method Retrospective case series at a tertiary medical center Results The suprastomal granuloma could be removed with the coblator in all 5 cases. Three were removed entirely endoscopically and 2 required additional external approach through the tracheal stoma for complete removal. There were no intraoperative or postoperative complications. One patient was subsequently decannulated and 2 patients have improved tolerance of their speaking valves. Two patients remain ventilator dependent, but their bleeding and difficulty with tracheostomy tube changes resolved. Three of the patients have had subsequent re-evaluation with bronchoscopy, demonstrating resolution or markedly decreased size of the granuloma. This technique is time efficient, simple and minimizes risks associated with other techniques. The relatively low temperature and use of continuous saline irrigation with the coblator device minimizes the risk of airway fires. Additionally, the risk of hypoxia from keeping a low fractional inspiratory oxygen level (FIO2) to prevent fire is avoided. The concurrent suction in the device decreases blood and tissue displacement into the distal airway. Conclusion Coblation can be used safely and effectively with an endoscopic or external approach to remove suprastomal granulomas in tracheostomy-dependent children. More studies that are larger and have longer follow-up are needed to evaluate the use of this technique.

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Coblation removal of large suprastomal tracheal granulomas

Cited by 17 publications

References 8 publications

Powered debridement of suprastomal granulation tissue to facilitate pediatric tracheotomy decannulation

Powered debridement of suprastomal granulation tissue to facilitate pediatric tracheotomy decannulation

Tracheotomy-coblation for acquired subglottic tracheal stenosis: a case report

Coblation of suprastomal granulomas in tracheostomy-dependent children

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