Coblation for Airway Pathologies: A Scoping Review.

Abstract

Coblation is a plasma-mediated ablative technology that removes tissue at low temperatures with minimal thermal injury. Although interest in its application to laryngotracheal pathologies has grown, the existing evidence remains fragmented and no consensus guidelines exist. We mapped the literature, characterized outcomes, and identified gaps for future research. Embase, PubMed, and Web of Science were searched using MeSH and free-text terms for laryngotracheal pathology and coblation. The protocol was registered on PROSPERO (CRD420251167760). The review followed PRISMA-ScR guidelines. Studies of any design reporting patient outcomes following coblation for laryngotracheal indications were eligible. Titles, abstracts, and full texts were independently screened by two reviewers, with discrepancies resolved by additional reviewers. Thirty studies encompassing 473 patients were included, spanning congenital abnormalities, vascular malformations, and cysts (n = 12), laryngotracheal stenosis or airway obstruction (n = 12), malignancy or benign tumors (n = 3), suprastomal granulation tissue (n = 2), and recurrent respiratory papillomatosis (n = 1). Reported outcomes were favorable and endpoints ranged from complete lesion resolution (congenital cysts) to decannulation or airway patency (stenosis) to palliative debulking (malignancy). Reintervention was low, exceeding 20% in only 6 of 20 multi-patient studies. No intraoperative mortality, major hemorrhage, or airway compromise was reported. Outcome reporting was heterogeneous; dysphonia and dysphagia were unreported in 18 and 20 studies, respectively. Coblation was associated with favorable reported outcomes and a low complication profile across diverse laryngotracheal pathologies, though outcome definitions and follow-up varied substantially. Prospective comparative studies with standardized reporting frameworks are needed to define coblation's role in laryngotracheal surgery. N/A.