Clinical Effect Analysis Of Surgery For Epiglottis Cysts With CO₂ Laser,Coblation And Electrocautery

Objective: To explore the clinical effect of CO2 laser compared with coblation and electrocautery for treating epiglottis cysts.Methods: The medical records of 93 patients with epiglottis cysts who underwent general anesthesia and suspensive laryngoscope surgery between January, 2009 and April, 2014 were assessed.All patients were divided into three groups based on surgical procedures: CO2 laser + microscope(briefly named CO2 laser group), n = 31; coblation + monitoring endoscope(briefly named coblation group), n = 30; electrocautery group + monitoring endoscope(briefly named electrocautery group), n = 32.To compare the effect of the treatments,operative time,intraoperative bleeding volume, cyst ruptured rate, postoperative pain duration, swelling wound’s regression time,postoperative complications and recurrence rate were investigated among these three groups.Results: The comparison among CO2 laser group, coblation group and electrocautery group showed a significant difference for operation time,intraoperative bleeding volume and cyst ruptured rate(P <0.05).The electrocautery group had significant difference for postoperative pain duration and swelling wound’s regression time compared with coblation group and CO2 laser group(P <0.05),while comparision between coblation group and CO2 laser group didn’t have any significant differences(P >0.05). No significant difference was noted for recurrence rate and postoperative complications of three procedures(P >0.05).Conclusion: 1. CO2 laser deserves clinical recommendation as the advantages of flexible adjustment,exquisite cut, single layer exfoliation, uniform force and less thermal damage to surrounding tissue.As easily coupled to microscope,it couldachieve the goal of superior surgical precision,specific location and considerable hemostatic effect.With CO2 laser treating epiglottis cysts, the prominence is light swelling, less complication and low recurrence rate. 2. Coblation has the superiority of low temperature on working interface, less heat penetration, light swelling as well as no radiation, smog and odor,but the disadvantage is rough cut without single layer exfoliation leading to easy cyst rupture and poor view with nonmicroscope. On account of pseudomembranelle falling off and granulation formation,coblation inferior to CO2 laser.3. Electrocautery has the weakness of poor power control, centralized thermal effect, poor hemostatic effect and inferior surgical precision resulting in more bleeding, easy cyst rupture long operation time, large tissue injury,slow mucosa recovery and high complication.