gms | German Medical Science

Microscopic CO₂-laser assisted tonsillectomy (TE) with protracting palatal sutures is a safe and effective surgical procedure, that seems to be unjustified neglected by medical community. The presented educational video shows as well the advantages of microscopic exposure of surgical field, as the benefits of CO₂-laser TE (Lumenis).

In presented case, pulsation in the right tonsillar fossa, representing an abnormal deviation of internal carotid artery (ICC) through tonsilar bed, was noted under microscopic amplification. Since snoring and mild OSA had been the indication for TE/LAUP, we only performed left sided TE and LAUP, followed by bilateral protracting sutures, not affecting the blood vessel . Post op, snoring and airway problems resolved, and atypical course of ICC could be verified.

CO₂-laser assisted TE/LAUP and protracting sutures complement one another perfectly and provide excellent results, without worsening post op complaints. Microscopic exposure is safer and blood loss typically less than 5 ml. In minors undergoing microscopic TE by CO₂-Laser or Ultracision [Schedler 2007], it was typically under 1 ml [1]. Since intra operative loss of blood seems to be the main determinant for severe complications and fatal outcomes in TE, improved safety in these potentially dangerous procedures should not be underestimated.