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Randomized Controlled Trial
. 2021 Sep-Oct;87(5):529-532.
doi: 10.1016/j.bjorl.2019.11.006. Epub 2019 Dec 12.

Acute tissue damage induced by monopolar microelectrodes and radiofrequency in vocal cords after transoral cordectomy

Jorge Basterra  1 , Nezly Mosquera  2 , Natsuki Oishi  3 , Ana Pérez  4 , Enrique Zapater  2
Affiliations
Randomized Controlled Trial

Acute tissue damage induced by monopolar microelectrodes and radiofrequency in vocal cords after transoral cordectomy

Jorge Basterra et al. Braz J Otorhinolaryngol. 2021 Sep-Oct.

Abstract

Introduction: In 2006 and 2009, we reported the levels of acute and chronic tissue damage after cordectomy associated with use of the microlectrodes using high frequency energy. In 2010, we shifted to radiofrequency rather than high frequency electrogenerators.

Objective: The aim of this study is to evaluate acute tissue damage in the larynx after cordectomy using microelectrodes coupled to a radiofrequencygenerator.

Methods: We studied 22 patients with a stage T1 glottic squamous cell carcinoma. The patients were randomly assigned to the two operating mode: cutting or coagulation (11 patients each mode). The strength of the study is that there are no previous studies on the effect of radiofrequency in human vocal cord.

Results: Tissue damage was milder when microelectrodes were coupled to a 4 MHz generator operating in the cutting mode. Thus, when using microelectrodes and radiofrequency, we recommend that the cutting mode be used for epithelial incision and the coagulation mode to treat the stroma and muscle and for final hemostasis.

Conclusion: Microelectrodes and radiofrequency in transoral laryngeal surgery produced mild tissue damage and offer an excellent alternative to the use of high frequency energy.

Keywords: Microelectrodes; Radiofrequency; Tissue damage; Vocal cord.

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Figures

Figure 1
Figure 1
Monopolar microelectrodes. Metal tips are 3 mm × 0.3 mm. Lengths’ of the shaft is 21 cm. Microelectrodes attached to the hand piece.
Figure 2
Figure 2
Bivalve laryngoscope in place. The angled fórceps (left hand) and the angled microelectrode (right hand), hands are off the field. Surgical microscope is then used.
Figure 3
Figure 3
A, Specimen of the surgical berth associated with the use of microelectrodes and radiofrequency in the coagulation mode (H&E, 40×). The epithelium exhibits a coagulation artefact (white arrow), necrosis, dehiscence, and pyknotic nuclei (empty arrow); sub epithelial haemorrhage is also apparent. B, Specimen of the surgical berth associated with the use of microelectrodes and radiofrequency in the cutting mode (H&E, 20×). The black arrow indicates the area of incision; the epithelium is preserved. The gray arrows indicate the deep margin corresponding to the cut zone. The white arrows indicate a small area with mild stromal damage. The change in coloration and thickening of the collagen bands covers less than one-third of the field.
Figure 4
Figure 4
Tissue damage scores of the generator modes used. The cutting mode causes less damage than the coagulation mode.
See this image and copyright information in PMC

References

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