In-Office Laser Treatment of RRP

In-office treatment of Recurrent Respiratory Papillomatosis (RRP) with a blue laser fiber and a channeled 4-way endoscope for optimal visualization, including the use of NBI to enhance the typical vascular patterns. An alternative to the surgical microlaryngoscopy approach in the OR.

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In-Office Vocal Fold Biopsy

In-office biopsy under local anesthesia of the anterior commissure using a 4-way channeled endoscope for easy accessibility and utilization of biopsy forceps.

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In-Office Ventricular Fold Injection

In-office injection of botulinum toxin into the ventricular folds of the larynx for spasmodic dysphonia using a 4-way endoscope for easy accessibility, visualization and use of a needle catheter.

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TransOral UltraSonic Surgery (TOUSS)

What is TOUSS?

TOUSS (TransOral UltraSonic Surgery) is a minimally invasive, endoscopic approach for benign and malignant lesions in the upper aerodigestive tract. It mainly utilizes the ultrasonic scalpel as a resection tool and bipolar energy as a hemostatic tool that improves the safety of the procedure. THUNDERBEAT is the only instrument that incorporates both ultrasound and bipolar energy in one device, thus enabling fast and effective tissue dissection and safe and reliable hemostasis. TOUSS uses technology available to most institutions and has emerged as an alternative to TransOral Robotic Surgery (TORS), offering all its advantages while avoiding the elevated costs of acquiring and maintaining a robotic surgical platform. TOUSS was developed by Dr. Mario Fernandez, Department Chief of Otorhinolaryngology at Hospital Universitario in Henares, Coslada, Madrid.

Benefits of TOUSS

The advantage of this technique in comparison with open techniques is avoiding the morbidity of external approaches, as the surgery is strictly limited to the lesion and its surgical margin. For this reason, the technique is especially intended for patients previously treated with chemoradiotherapy, where open approaches have a more marked morbidity.

Compared to other transoral approaches such as laser microscopic surgery, TOUSS brings with it the benefits of the endoscopic approach, which:

• allows a greater magnification of the focused surgical field (unlike the microscope, which only has a single extremely zoomed-in plane of focus above everything)
• is not dependent on adequate external exposure for its realization