Powered laryngeal shavers and laryngeal papillomatosis: a preliminary report

Carbon dioxide (CO2) laser ablation is widely accepted as the most effectiv e first line surgical treatment of recurrent laryngeal papilloma. However, vaporization of papilloma with the CO2 laser exposes the patient and staff to a potentially infective plume. Furthermore, unsuitable pathological tiss ue specimens and scarring of the surrounding laryngeal architecture are ine vitable consequences of the thermal energy generated by this instrument. Fo llowing their innovative use in endonasal surgery, powered laryngeal micror esecting instruments (Xomed Shavers) have been developed for laryngeal surg ery. We assessed the value of these new instruments in five patients who ha d previously undergone laser ablation. All of the patients reported that th eir postoperative recovery was the 'same as' or 'better than' that followin g laser surgery. The surgeon reported that though there was more bleeding, shaver excision of papilloma provided good clearance of disease, easy colle ction of pathological samples; and a potentially safer and faster alternati ve to laser excision.