Objective: To compare functional and cost-effectiveness of awake transnasal laser assisted-surgery versus microlaryngeal surgery for benign laryngeal lesions.
Methods: This was a prospective non-inferiority randomized controlled trial conducted from May 2021 to December 2022 at two tertiary referral hospitals in Hong Kong. Patients were block-randomized to receive either awake transnasal laser-assisted surgery or microlaryngeal surgery, with post-operative follow-up in a multidisciplinary voice clinic for 1-year. Primary outcome was Voice Handicap Index (VHI-30). Secondary outcomes included operation time, complications, length of stay, peri-operative discomfort, recurrence, and medical costs.
Results: Sixty-one patients were randomized to either awake transnasal laser-assisted surgery (n = 30) and microlaryngeal surgery (n = 31). Both groups had comparable demographics and laryngeal pathologies. Both groups showed significant improvement of VHI-30 score over time and had comparable post-operative VHI-30. Awake transnasal laser-assisted surgery group had a significantly shorter length of stay (0.5 vs. 1 day) and less throat discomfort (2 vs. 4) compared to microlaryngeal surgery group. Intraoperative complications were more common in microlaryngeal surgery group (14.3% vs. 0%). Otherwise, both groups had similar operative time and recurrence rate. Cost-analysis showed a significantly lower hospital cost for awake transnasal laser-assisted surgery (USD 3090) compared to microlaryngeal surgery group (USD 5120).
Conclusion: Awake transnasal laser-assisted surgery was safe, functionally non-inferior, as measured by VHI-30, to microlaryngeal surgery in managing benign laryngeal lesions, while superior to microlaryngeal surgery in peri-operative discomfort and medical costs.
Level Of Evidence: 2 Laryngoscope, 134:3732-3740, 2024.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/lary.31481 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Does the TruBlue Laser Set Microlaryngoscopy Equipment on Fire? A Systematic Evaluation.
Laryngoscope
December 2024
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
Introduction: The risk of fire during laser microlaryngoscopy is well known. However, limited information is available about fire risk with the novel TruBlue laser. This study systematically evaluates its interactions with common surgical supplies, offering valuable insights into safety considerations for surgeons.
View Article and Find Full Text PDFThe clinical application of transcutaneous carbon dioxide monitoring during rigid bronchoscopy or microlaryngeal surgery in children.
J Clin Anesth
January 2025
Department of Anesthesiology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Study Objective: During rigid bronchoscopies and microlaryngeal surgery (MLS) in children, there is currently no reliable method for managing ventilation strategies based on carbon dioxide (CO) levels. This study aimed to investigate the effects of the clinical implementation of transcutaneous CO (tcPCO) monitoring during rigid bronchoscopies or MLS.
Design: Prospective observational study.
Safety of Small-Diameter Endotracheal Tubes in Microlaryngeal Surgery.
Laryngoscope
October 2024
Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, U.S.A.
Objectives: Microlaryngeal surgeries require unique considerations for airway management to facilitate patient safety and adequate surgical exposure. Small-diameter endotracheal tubes (ETTs) are widely used but have raised concerns regarding patient safety, including questions about the potential for barotrauma, effective ventilation, and adequate oxygenation. We hypothesize that small ETTs will prove to be safe in a variety of cases.
View Article and Find Full Text PDFDevelopment of the "LAser Surgical skills Evaluation for Residents" (LASER) Scale Through a Modified Delphi Method.
J Otolaryngol Head Neck Surg
October 2024
Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Background: The CO laser is frequently used during microlaryngeal surgery (MLS) for a variety of pathology including laryngeal malignancy and stenosis. Learning how to use the laser safely is part of the curriculum for every otolaryngology resident. However, assessment of laryngoscopy technical skills can be challenging for supervisors, making it difficult to adequately provide feedback to trainees.
View Article and Find Full Text PDFTransoral Laser Microlaryngeal Surgery with MLT Tubes: A Retrospective Case Series.
Indian J Otolaryngol Head Neck Surg
October 2024
Head and Neck Surgery and Oncology, Cyetcare Cancer Hospitals, Bengaluru, India.
To evaluate effectiveness of using MLT tubes for transoral laser MLS in terms of surgical visualization, complete excision of vocal cord lesions, maintenance of adequate oxygenation and ventilation and the occurrence of any airway related complications. In a retrospective case series study, review of electronic medical records was conducted for 64 patients who underwent transoral laser MLS over an 18-month period. The collected data included vital parameters, mode of ventilation, ET tube details, surgical field of vision, perioperative adverse events and postoperative ventilation requirements.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!