THE EFFECT OF MICRODEBRIDERS ON TISSUE FOR HISTOLOGICAL DIAGNOSIS

Microdebriders are an innovation in endonasal surgery which enable acc urate and precise removal of tissue without damaging the surrounding m ucosa. Concern has been expressed, however, that the instrument may re nder excised tissue unsuitable for histological diagnosis. This proble m is further compounded by the fact that the Hummer (Stryker UK Ltd) m icrodebrider does not incorporate a mechanism for collecting specimens at the time of removal. Twenty-one patients with sinonasal polyposis underwent endoscopic sinus surgery using the microdebrider. Specimens were collected al the time of surgery via an in-line specimen trap. Si multaneous conventional biopsies of adjacent tissue were taken for com parison. The tissue was fixed in formalin then routinely processed to paraffin wax prior to staining with haematoxylin and eosin (H&E). A hi stological diagnosis was made in all 21 patients. A single unsuspected transitional cell papilloma was found. The remaining 20 specimens con sisted of inflammatory nasal polypi. In two non-caseating granulomas w ere identified. Traumatic artefact was limited to the respiratory epit helium. The sub-epithelial tissue was unaffected and metaplastic epith elium appeared intact. The use of microdebriders does not preclude the submission of tissue for histological analysis. Tissue obtained has l imited artefact and is suitable for pathological diagnosis.