Successful treatment of oral human papilloma by local injection 5-aminolevulinic acid-mediated photodynamic therapy: A case report

Efficacy of photodynamic therapy for oral multifocal papilloma: a case report

Oral papilloma, a frequently encountered benign lesion, can be managed effectively with various treatments. A unique case of oral mucosal papilloma extending from the buccal fat pad region to the corner of the mouth is presented here. Although papilloma larger than 10 mm2 are associated with a high risk of becoming cancerous and should be treated promptly, the papilloma in this case would have been difficult to resect due to involvement of the parotid duct opening and the corner of the mouth. Topical external application of 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) was employed successfully in this case, with no recurrence at 20 months of follow-up. Therefore, ALA-PDT may represent a promising therapeutic option for challenging cases of multifocal papilloma of the oral mucosal.

Potential of photodynamic therapy in the management of infectious oral diseases

Photodynamic therapy (PDT) can take place in the presence of three elements: Light with an appropriate wavelength; a photosensitizer; and the presence of oxygen. This type of treatment is very effective overall against bacterial, viral and mycotic cells. In the last 10 years many papers have been published on PDT with different types of photosensitizers (e.g., methylene blue, toluidine blue, indocyanine green, curcumin-based photosensitizers), different wavelengths (e.g., 460 nm, 630 nm, 660 nm, 810 nm) and various parameters (e.g., power of the light, time of illumination, number of sessions). In the scientific literature all types of PDT seem very effective, even if it is difficult to find a standard protocol for each oral pathology. PDT could be an interesting way to treat some dangerous oral infections refractory to common pharmacological therapies, such as candidiasis from multidrug-resistant Candida spp.

Office-Based Photodynamic Therapy Using Locally Applied 5-aminolevulinic Acid and 635 nm Laser for Laryngeal Leukoplakia

OBJECTIVE

Photodynamic therapy (PDT) is a minimally invasive method with strong tissue selectivity and nonthermal effects. We aim to investigate the efficacy of an in-office method utilizing PDT with local application of 5-aminolevulinic acid (ALA) and 635 nm diode laser for treating laryngeal leukoplakia.

STUDY DESIGN

Retrospective cohort study.

SETTING

Outpatient clinic-tertiary medical center.

METHODS

This study reviewed 32 patients with laryngeal leukoplakia, including 11 recurrent cases after surgery. All the procedures were performed in an office setting under topical anesthesia. Fifteen percent ALA solution was locally applied to the lesion through a flexible laryngoscope. Light illumination was performed using a 635 nm diode laser through a 400 μm optic fiber. The power density was 165 mW/cm² to reach 100 J/cm² . Results of laryngostroboscopy and voice evaluation during follow-up were collected.

RESULTS

The mean follow-up was 7.91 ± 4.83 (3-18) months. Thirty-nine procedures were performed, including 1 session for 27 patients, 2 sessions for 3 patients, and 3 sessions for 2 patients. The total response rate was 96.875% (31/32), including complete responses in 26 (81.25%) patients, partial responses in 5 patients (15.625%), and no response in 1 patient (3.125%). It appeared that PDT selectively eliminated the leukoplakia without affecting lamina propria and the surrounding normal mucosa remained unharmed. Scores of Voice Handicap Index-10, jitter, shimmer, and harmonic-to-noise ratio were significantly improved after PDT.

CONCLUSION

Office-based PDT is an effective, repeatable, and practical method for treating laryngeal leukoplakia. Local application of ALA is sufficient to achieve photodynamic reactions. PDT could eliminate laryngeal leukoplakia selectively while protecting the normal laryngeal structure.

Photodynamic therapy-a promising treatment of oral mucosal infections

The treatment of oral mucosal infections is increasingly challenging owing to antibiotic resistance. Therefore, alternative antimicrobial strategies are urgently required. Photodynamic therapy (PDT) has attracted attention for the treatment of oral mucosal infections because of its ability to effectively inactivate drug-resistant bacteria, completely heal clinical infectious lesions and usually offers only mild adverse reactions. This review briefly summarizes relevant scientific data and published papers and discusses the potential mechanism and application of PDT in the treatment of oral mucosal infections.