Advances in Microdebrider Technology

Tang, Dennis M.; Lobo, Brian C.; D’Anza, Brian; Woodard, Troy D.; Sindwani, Raj

doi:10.1016/j.otc.2017.01.009

Cited by 16 publications

(21 citation statements)

References 11 publications

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“…The pedal-operated microdebrider enables surgeons to perform surgery with lower morbidity. 1,3 Yet, while any instrument can cause iatrogenic injury, the microdebrider may pose significant additional risks. For example, even seemingly minor trauma can result in damage to the anterior ethmoid artery, transection of extraocular muscles, 2 or intracranial injury.…”

Section: Discussionmentioning

confidence: 99%

“…The pedal-operated microdebrider has revolutionized endonasal surgery, allowing otolaryngologists to perform surgeries with greater precision, accuracy, and efficiency. 1 However, the speed of the rotating blade also increases the potential for complications to occur quickly, including damage to adjacent structures like the orbit and skull base. 1,2 Thus, optimizing surgeon body position while using the pedal-operated tool is crucial to avoid iatrogenic injury.…”

Section: Introductionmentioning

confidence: 99%

“…1 However, the speed of the rotating blade also increases the potential for complications to occur quickly, including damage to adjacent structures like the orbit and skull base. 1,2 Thus, optimizing surgeon body position while using the pedal-operated tool is crucial to avoid iatrogenic injury.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of body position on reaction time: A simulation for foot pedal‐activated instruments

Breinholt¹,

Ahearn²,

Liu³

et al. 2022

Int Forum Allergy Rhinol

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of body position on reaction time: A simulation for foot pedal‐activated instruments

Breinholt¹,

Ahearn²,

Liu³

et al. 2022

Int Forum Allergy Rhinol

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show abstract

“…It is important to realize that while the microdebrider has revolutionized endoscopic sinus surgery by providing real-time, precise resection of diseased mucosa in a confined surgical field, the potential for rapid surgical complications must be viewed as an ever-present concern. As the microdebrider offers minimal tactile feedback in addition to accelerated tissue resection speeds as compared to conventional instrumentation (9) , the knowledge of anatomical landmarks and proper surgical technique become ever more critical in preventing adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…(8) However, this concept has been challenged as evidenced by numerous case studies that have shown that, when misplaced, the indiscriminate aspirating function and limited tactile feedback of the microdebrider can lead to major surgical complications. (9–12)…”

Section: Introductionmentioning

confidence: 99%

Modeling microdebrider-mediated ophthalmic damage: a word of caution in endoscopic sinus surgery

Worden¹,

A.²,

Senior³

et al. 2019

RHINOL

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Background: The microdebrider has become nearly universal in the treatment of sinonasal pathology; however, recent case reports have demonstrated the potential for major ophthalmic complications. The goal of this study was twofold: 1) determine the anatomical proximity of ophthalmic structures to the paranasal sinuses, and 2) assess the timeframe at which ophthalmic injury may occur with the use of a microdebrider during FESS utilizing a cadaveric model. Methodology/Principal: Computed tomography scans from 50 patients were accessed retrospectively. The distances between the lamina papyracea (LP) and orbital structures were determined at varying depths. Seven cadavers (14 sides) were studied using three microdebrider systems operated by otolaryngology residents. Following removal of a window of LP, the time from activation of the microdebrider on the periorbita until transection of the medial rectus (MR), optic nerve (ON), and to aspiration of the globe were measured. Results: The mean distance between the LP and MR at the level of the anterior aspect of the anterior ethmoid and basal lamella were 3.59 ±1.2mm and 1.5 ±0.8mm, respectively. The mean distance between the LP and ON at the level of the basal lamella was 8.1 ±2.1mm. Mean transection times for the MR and ON were 13.4 ± 7.3 seconds and 37.3 ± 9.2 seconds, respectively, with minimum times of 4 seconds and 26 seconds. Conclusions: The proximity of orbital structures to the paranasal sinuses and the rapidity of ophthalmic damage following violation of the periorbita reaffirms the need for cautious use of the microdebrider during FESS.

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Complications Associated with Microdebriders in Otolaryngology Procedures from 2011 to 2021: A MAUDE Study

Magge,

Lee,

Shaver

et al. 2023

OTO Open

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ObjectiveThe microdebrider is a powered surgical instrument that is widely used in the field of otolaryngology. We aim to identify the type and frequency of device malfunctions, patient complications, and subsequent interventions related to the use of microdebriders.Study DesignCross‐sectional analysis.SettingThe US Food and Drug Administration (FDA) 2011 to 2021 Manufacturer and User Facility Device Experience (MAUDE) database.MethodsThe MAUDE database was queried for reports of “microdebrider,” with adverse events selected that pertained to usage in head and neck surgeries from January 1, 2011 to December 31, 2021.ResultsThere were 282 adverse events in 267 individual medical device reports (MDR). Although the majority of the reports did not specify the specific operation, endoscopic sinus surgery was the most common reported procedure (89, 33.3%). The most common cause of device malfunction was due to a broken piece (120, 48.2%) followed by overheating of the microdebrider motor (78, 31.3%). Of the reports which specified patient injury, the most commonly reported was “unintentional tissue damage,” (10, 32.3%).ConclusionThe microdebrider has demonstrated utility within the field of otolaryngology, but is not without risk of malfunction that can cause patient injury. By understanding possible risks of microdebrider usage, including tissue damage, burns, and bleeds caused by device malfunction or operator error, physicians can be better prepared to address complications and educate patients.

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Advances in Microdebrider Technology

Cited by 16 publications

References 11 publications

Effect of body position on reaction time: A simulation for foot pedal‐activated instruments

Effect of body position on reaction time: A simulation for foot pedal‐activated instruments

Modeling microdebrider-mediated ophthalmic damage: a word of caution in endoscopic sinus surgery

Complications Associated with Microdebriders in Otolaryngology Procedures from 2011 to 2021: A MAUDE Study

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