American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 31, Issue 5 , Pages 356-359, September 2010

Device-related risk of fire in oropharyngeal surgery: a mechanical model☆☆☆★

  • Soham Roy, MD, FACS, FAAP

      Affiliations

    • Texas Ear Nose and Throat Consultants, Children's ENT of Houston, Houston, TX, USA
    • Division of Pediatric Otolaryngology, University of Texas at Houston, Houston, TX, USA
    • Corresponding Author InformationCorresponding author. Texas Ear Nose and Throat Consultants Children's ENT of Houston 6550 Fannin Street Suite 2001 Houston, Texas 77030. Tel.: +1 713 796 2001; fax: +1 713 796 2349.
    • ,
  • Lee P. Smith, MD

      Affiliations

    • Division of Otolaryngology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA

Received 17 November 2008 published online 06 July 2009.

Abstract 

Objective

The aim of this study was to evaluate the fire risk for an electrosurgical device (Bovie) as compared with a bipolar radiofrequency ablation wand (Coblator) in a mechanical model of oropharyngeal surgery.

Methods

An endotracheal tube was inserted into the cranial end of a degutted, whole raw chicken through which 100% oxygen was piped at 10 L/min. An electrosurgical device (15 W, coagulate mode) and bipolar radiofrequency ablation wand (9, 7, and 3 in ablate mode; 5 and 3 in coagulate mode) were activated in the central cavity. All experimental conditions were tested for 4 minutes, or until a positive result was achieved. All trials were repeated to ensure accuracy.

Results

Ignition was obtained with a sustained fire when using the electrosurgical device for between 25 and 80 seconds. Under all 5 experimental conditions, no ignition or sustained fire could be produced using the radiofrequency ablation wand. After 20 sustained minutes of continuous plasma ablation in the chicken cavity without ignition, the electrosurgical device was able to ignite a fire in 25 seconds in the same cavity.

Conclusions

Although electrosurgical devices present a significant risk of fire during open cavity surgery in oxygen-enriched environments, that risk seems to be eliminated with bipolar radiofrequency plasma ablation.

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☆ Drs Roy and Smith have served as consultants for ArthroCare Corporation (Sunnyvale, CA). ArthroCare provided funding for use of an independent laboratory (Exponent Engineering and Scientific Consulting, Menlo Park, CA) where the experiments took place. ArthroCare had no role in planning, conducting, or analyzing this study, its results, or this article submission.

☆☆ Funding source: ArthroCare Corporation (Sunnyvale, CA) provided funding for use of an independent laboratory and engineering team (Exponent Engineering and Scientific Consulting, Menlo Park, CA). ArthroCare had no role in planning, conducting, or analyzing this study, its results, or this presentation. Both authors have served as consultants for ArthroCare.

★ Presented as an oral presentation at the American Academy of Otolaryngology-Head and Neck Surgery, Chicago, IL, September 2008.

PII: S0196-0709(09)00119-7

doi:10.1016/j.amjoto.2009.05.006

American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 31, Issue 5 , Pages 356-359, September 2010

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