Injuries of Different Surgical Instruments on the Vocal Folds of Dogs

Jiangping Song; Zhisen Shen; Yuna Zhang; Shanshan Gu; Hongxia Deng

doi:10.1016/j.jvoice.2023.12.020

Injuries of Different Surgical Instruments on the Vocal Folds of Dogs

J Voice. 2024 Feb 12:S0892-1997(23)00411-3. doi: 10.1016/j.jvoice.2023.12.020. Online ahead of print.

Authors

Jiangping Song¹, Zhisen Shen², Yuna Zhang³, Shanshan Gu⁴, Hongxia Deng⁴

Affiliations

¹ Ningbo University, School of Medicine, The Affiliated Lihuili Hospital, Ningbo, Zhejiang 315040, China; Department of Otolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang 315040, China; Medical School of Ningbo University, Ningbo, Zhejiang 315211, China.
² Department of Otolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang 315040, China. Electronic address: szs7216@163.com.
³ Department of Operating Room, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang 315040, China.
⁴ Department of Otolaryngology-Head and Neck Surgery, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, Zhejiang 315040, China.

PMID: 38350807
DOI: 10.1016/j.jvoice.2023.12.020

Abstract

Objective: This study aimed to compare the damage of vocal folds caused by four different surgical instruments: CO₂ laser, electrosurgical knife, plasma radiofrequency ablation, and steel knife.

Study design: Randomized controlled study.

Methods: The CO₂ laser, electrosurgical knife, plasma radiofrequency ablation, steel knife, and other instruments were used to simulate the laryngeal microsurgery on experimental dogs. Both total vocal fold resection and punctate ablation were performed. On the day of surgery and 6 days later, the vocal fold tissue from the surgical site was removed for histological evaluation. The extent of vocal fold damage was assessed using the automatic digital pathological scanning system.

Results: We detected varying degrees of damage to the laryngeal tissues. Only the steel knife caused epidermal defects on the vocal fold tissue, while other instruments produced thermal damage of different degrees. Furthermore, the steel knife also showed better and faster healing. The plasma radiofrequency ablation was found to cause more severe thermal burns to vocal folds than other surgical instruments (P < 0.05). Six days postsurgery the inflammatory reaction from the steel knife had basically subsided, with only hyperplasia and tissue repair visible microscopically, showing the best healing degree. On the other hand, the radiofrequency ablation group showed the heaviest inflammatory reaction, indicating relatively poor prognosis (P < 0.05).

Conclusion: Compared with the CO₂ laser, the electrotome and steel knife showed less damage and better healing, while the plasma radiofrequency ablation showed the most obvious thermal burns to laryngeal and vocal tissues during surgery, with relatively poor healing.

Keywords: CO(2) laser; Dog; Electrosurgical knife; Radiofrequency ablation; Steel knife; Vocal folds.