An underreported complication of laryngeal microdebrider: vocal fold web and granuloma: a case report.

OBJECTIVES/HYPOTHESIS: The microdebrider has become a valuable instrument for otolaryngologists. It is now used in the larynx for treatment of recurrent respiratory papillomatosis, laryngeal stenosis, and debridement of large cancers for airway control. There are few reported complications reported with the use of the microdebrider in the larynx.

STUDY

DESIGN

A case report.

METHODS

A patient with a vocal fold polyp underwent removal of the polyp with a microdebrider at an outside institution. He presented to our clinic 2 months after the excision with a severely strained near aphonic voice. On rigid stroboscopic examination we saw a large anterior commisure laryngeal web with a granuloma. This was repaired by granuloma excision, web lysis, buccal graft, and laryngeal stent placement.

CONCLUSIONS

The microdebrider is an extremely valuable tool for the otolaryngologist. Violation of the epithelium and the lamina propria with muscle exposure can result in serious damage to the vocal folds. When using powered instrumentation the surgeon should use the upmost caution in the larynx to avoid causing debilitating injury and scar with subsequent dysphonia.