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Powered debridement of suprastomal granulation tissue to facilitate pediatric tracheotomy decannulation
Cynthia Chen1, John P Bent, Sanjay R Parikh
1Dept. of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, United States. Cchen@montefiore.org
Objective:
To compare suprastomal granulation tissue (SSGT) removal using the microdebrider with other common methods of excision.
Methods:
Retrospective review (n=21) of SSGT excision at a tertiary care pediatric hospital (2004-10). Outcome measures included intraoperative blood loss, operative time, decannulation rates, and complications.
Results:
10 children underwent excision of SSGT via powered SSGT debridement and 8 were decannulated (80% success rate). Of the other 11 patients who had manually non-powered techniques (kerrison rongeur, laryngeal microinstruments, or optical forceps), 7 were decannulated (63% success rate). Operative time was on average shorter than all other procedures, but not significantly (p=0.101). There was no significant difference in blood loss when powered debridement was compared to other techniques (p=0.872). There were no significant complications encountered in our patients who received SSGT powered debridement.
Conclusions:
Endoscopic powered SSGT debridement is a simple and useful tool in the process of pediatric tracheotomy decannulation with superior decannulation rate, shorter operative time, and comparable blood loss to other techniques.
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