OBJECTIVE To investigate the advantages of applying microdebrider re- moval of juvenile-onset recurrent respiratory papillary epithelioma (JO- RRP), using an endoscopy-assisted prop-up laryngoscope. METHODS The degree of severity of the neoplasms was divided into 3 scores (i.e. 1 point for a slight degree, 2 points for a moderate and 3 points for a severe degree). The involvement of 22 respiratory and diges- tive sub-areas was evaluated and the total accumulative scoring and the scores for the lesions in the vocal area were calculated and sub - grouped. All the papillary epitheliomas were excised using a laryngeal micro-debrider or the micro laryngeal forceps under endoscopy-assist- ed suspension laryngoscopy. The differences between applications of the two modes of treatment for the cases of the groups with same scoring were compared as follows: the operation time, interval of operation, recent vocal quality after operation, postoperative scarring and incision of the trachea, as well as the distribution of tumors in a re-operation. RESULTS The 142 operative procedures were performed in 33 pediatric patients, with application of a laryngeal microdebrider in 14 cases and ex- cision in 19. Compared to the excision group (EG), the laryngeal mi- crodebrider group (MDG) displayed many superior features, such as a short operation time, long interval between operations, obvious improve- ment in vocal quality soon after operation, and a low frequency of subse- quent tumors. There was a significant difference between these modes of the operation. A postoperative incision of the trachea was required in 2 cases of EG, whereas no post-operation was needed in the MDG. CONCLUSION There are many advantages in using laryngeal micro-de- brider removal of JO -RRP. The procedure is simple and convenient, having a distinct operating field, precise incision, minor wounds, fewer complications and better vocal quality soon after operation, as well as quicker rehabilitation and longer intervals between operations, etc.
Wenbin Lei Zhenzhong Su Weiping Wen Liping Chai Aiyun Jiang Jian Li
