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Chadwick KA, Andreadis K, Sulica L. Prospective Outcomes of Microlaryngoscopy Versus Office Laser Photoangiolysis for Vocal Fold Polyps. Laryngoscope 2024; 134 Suppl 8:S1-S20. [PMID: 38742623 DOI: 10.1002/lary.31484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/02/2024] [Accepted: 04/17/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE(S) The objective of this study is to compare treatment outcomes for vocal fold polyps (VFPs) between operating room microlaryngoscopy and office-based photoangiolysis with the potassium titanyl phosphate (KTP) laser. METHODS Prospective nonrandomized cohort study of patients with VFPs undergoing microlaryngoscopy ("OR group") or KTP laser photoangiolysis ("KTP group"). Voice outcomes (patient-reported outcome measures [Voice Handicap Index-10 (VHI-10) and Singing VHI-10 (SVHI-10)], auditory-perceptual measures [Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V)], videostroboscopic characteristics [Voice-Vibratory Assessment of Laryngeal Imaging (VALI)], and acoustic and aerodynamic measures) were performed at baseline and regular intervals after intervention. RESULTS Forty-four subjects (17 OR group, 27 KTP group) with VFPs were enrolled. Mean VHI-10 significantly improved from baseline to each follow-up interval in both groups, except for the 1-2-week interval in the OR group. Mean SVHI-10 improved for both groups at some intervals. Growth curve models and time-to-event analyses for patient-reported outcomes did not differ between groups. There were significant improvements in all categories of auditory-perceptual voice quality and some categories of videostroboscopic characteristics in both groups. No significant trends were identified in acoustic and aerodynamic measures. Improvements in most outcomes did not significantly differ between groups or based on polyp size. There were no major complications. CONCLUSIONS Significant improvements in patient-reported voice outcomes measures, auditory-perceptual voice evaluation, and videostroboscopic characteristics occur following surgical treatment of vocal fold polyps with either microlaryngoscopy or office-based KTP laser. Long-term voice outcomes do not significantly differ between treatment modalities. LEVEL OF EVIDENCE 3 Laryngoscope, 134:S1-S20, 2024.
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Affiliation(s)
- Keith A Chadwick
- Division of Otolaryngology-Head & Neck Surgery, Stony Brook University, Stony Brook, New York, USA
| | | | - Lucian Sulica
- Department of Otolaryngology-Head and Neck Surgery, The Sean Parker Institute for the Voice, Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, New York, USA
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Filauro M, Ioppi A, Vallin A, Sampieri C, De Vecchi M, Gabella G, Benzi P, Mora F, Peretti G. Office-Based Treatment of Vocal Fold Polyps and Reinke's Edema: A Rational Comparison With Suspension Laryngoscopy. Laryngoscope 2023; 133:2665-2672. [PMID: 36647733 DOI: 10.1002/lary.30576] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/17/2022] [Accepted: 01/05/2023] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Benign laryngeal lesions have traditionally been treated through suspension laryngoscopy under general anesthesia (GA). Recently, the development of operative videoendoscopes coupled with photoangiolytic lasers has allowed clinicians to treat these conditions in the outpatient clinic. We report our experience in the office-based (OB) setting for the treatment of patients affected by vocal fold polyps (VFPs) and Reinke's edema (RE), comparing it to patients treated under GA. METHODS A retrospective analysis was conducted on patients affected by VFP or RE. A 445 nm diode blue laser was used through the operative channel of a flexible video-endoscope for OB procedures, while GA surgeries were carried out with cold steel instrumentation. The Voice Handicap Index-10 (VHI-10) represented the primary outcome. Endoscopic outcomes, duration, and morbidity of the procedures were investigated as secondary outcomes. RESULTS A total of 153 patients were retrospectively enrolled. 52 were treated in an OB setting, while 91 underwent GA. Regarding patients with RE, both the OB and GA cohorts showed a significant improvement in VHI-10 (from 12.7 to 2.6 and 19.5 to 5.1, respectively; p < 0.001), as did those with VFPs (from 11.8 to 2.3 and 15.9 to 2.9 respectively; p < 0.001). No differences were found when comparing VHI-10 in the OB and GA cohorts. The mean procedural time of OB treatment (4.9 min) was significantly shorter than GA (37.1 min). No adverse events were reported. CONCLUSION Our data demonstrate the efficacy and safety of the OB setting. For selected patients, OB treatments offer comparable vocal outcomes, favorable morbidity, and reduced operation times, making them an appealing alternative to the traditional approach. LEVEL OF EVIDENCE 3 Laryngoscope, 133:2665-2672, 2023.
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Affiliation(s)
- Marta Filauro
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
- Department of Medical Science (DIMES), University of Genoa, Genoa, Italy
| | - Alessandro Ioppi
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Alberto Vallin
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Claudio Sampieri
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Marta De Vecchi
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Giulia Gabella
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Pietro Benzi
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Francesco Mora
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Giorgio Peretti
- Unit of Otorhinolaryngology - Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
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Hamdan AL, Hosri J, Feghali PAR, Abi Zeid Daou C, Ghanem A. Office-based Blue Laser Therapy of Vocal Fold Polyps: A Cohort of 18 Patients: Blue Laser Therapy of Vocal Fold Polyps. Laryngoscope 2023; 133:2712-2718. [PMID: 36752582 DOI: 10.1002/lary.30602] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/21/2022] [Accepted: 01/22/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To investigate the effect of office-based blue laser therapy of vocal fold polyps on voice. METHODS The medical records and video recordings of patients who underwent office-based laser therapy in a tertiary referral center between February 2020 and May 2020, and May 2021 and October 2022 was conducted. Only patients with vocal fold polyps who had undergone office-based blue laser therapy were included. The voice was evaluated before and after surgery using the Voice Handicap Index-10 (VHI-10), GRB perceptual evaluation, acoustic analysis, and maximum phonation time. RESULTS A total of 18 patients were included. The mean age of the study group was 52.5 ± 11.94 years. The male-to-female ratio was 2:1. Ten patients of the total group (53.6%) had hemorrhagic polyps and the most common site was the mid-third of the vocal fold. All patients who presented for follow-up (n = 15) had partial or complete regression of the lesion (4 and 11, respectively). There was a significant decrease in the mean score of VHI-10 (17.6 ± 9.97 vs. 4.27 ± 5.76, p < 0.001) and in the means of grade of dysphonia (2.0 ± 0.73 to 0.5 ± 0.63, p < 0.001), roughness (1.88 ± 0.81 to 0.44 ± 0.51, p < 0.001) and breathiness (0.81 ± 0.75 to 0.13 ± 0.34 p < 0.001). There was also a marked decrease in the perturbation parameters (jitter and shimmer) and a significant increase in the MPT from 10.66 ± 4.22 s to 14.26 ± 6.26 s (p = 0.028). CONCLUSION Office-based blue laser therapy is an effective treatment modality in patients with vocal fold polyps. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2712-2718, 2023.
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Affiliation(s)
- Abdul-Latif Hamdan
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Jad Hosri
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Patrick Abou Raji Feghali
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Christophe Abi Zeid Daou
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Anthony Ghanem
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
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González-Rodríguez H, Mayo-Yáñez M, Maria-Saibene A, Allevi F, Chiesa-Estomba CM, Vaira LA, Lechien JR. Indications, Efficacy, Safety, and Clinical Outcomes of 585 nm Pulsed Dye Laser in Non-Malignant Laryngeal Lesions: A Systematic Review. J Pers Med 2023; 13:1374. [PMID: 37763142 PMCID: PMC10533112 DOI: 10.3390/jpm13091374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
The objective of this manuscript was to review the indications, efficacy, and safety of a 585 nm pulsed dye laser (PDL) in non-malignant laryngeal lesions. Following the PRISMA statement recommendations, three independent authors searched for articles published in PubMed/MEDLINE, the Cochrane Library, Google Scholar, Scielo, and Web of Science. A bias analysis was performed following NICE guidance tools. From the 506 identified publications, 19 observational studies met the inclusion criteria. The PDL improves vocal quality objectively and subjectively in vascular lesions (p < 0.005) and improves vocal quality in patients with dysplasia/leukoplasia without changing the natural history of the disease compared to other treatments. Reinke's edema and granulomas require an average of 1.5 PDL sessions for resolution. Treatment of recurrent respiratory papillomatosis requires multiple sessions, with complete remission achieved in 50-70% of patients. Regardless of the lesion, the tolerance of the procedure under local anesthesia is exceptional (84-97%), and the results in terms of regression and vocal quality are promising. The complication rate is minimal, and the procedure does not interfere with other treatment alternatives. There is no consensus on laser settings. The lack of consistent use in evaluating vocal outcomes, whether objective or subjective, prevents the comparability between studies. The 585 nm pulsed dye laser appears to be an effective and safe therapeutic option in patients with non-malignant laryngeal pathology. Future controlled studies are needed to compare the 585 nm pulsed dye laser with other lasers or cold instrument procedures.
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Affiliation(s)
- Henar González-Rodríguez
- Otorhinolaryngology—Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Spain
| | - Miguel Mayo-Yáñez
- Otorhinolaryngology—Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Spain
- Young-Otolaryngologists of the International Federation of Oto-Rhino-Laryngological Societies (YO-IFOS), Research Study Group, 75000 Paris, France; (A.M.-S.); (F.A.); (C.M.C.-E.); (L.A.V.); (J.R.L.)
| | - Alberto Maria-Saibene
- Young-Otolaryngologists of the International Federation of Oto-Rhino-Laryngological Societies (YO-IFOS), Research Study Group, 75000 Paris, France; (A.M.-S.); (F.A.); (C.M.C.-E.); (L.A.V.); (J.R.L.)
- Otolaryngology Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, Italy
| | - Fabiana Allevi
- Young-Otolaryngologists of the International Federation of Oto-Rhino-Laryngological Societies (YO-IFOS), Research Study Group, 75000 Paris, France; (A.M.-S.); (F.A.); (C.M.C.-E.); (L.A.V.); (J.R.L.)
- Maxillofacial Surgery Unit, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, 20142 Milan, Italy
| | - Carlos M. Chiesa-Estomba
- Young-Otolaryngologists of the International Federation of Oto-Rhino-Laryngological Societies (YO-IFOS), Research Study Group, 75000 Paris, France; (A.M.-S.); (F.A.); (C.M.C.-E.); (L.A.V.); (J.R.L.)
- Otorhinolaryngology—Head and Neck Surgery Department, Hospital Universitario Donostia—Biodonostia Research Institute, 20014 Donostia, Spain
| | - Luigi A. Vaira
- Young-Otolaryngologists of the International Federation of Oto-Rhino-Laryngological Societies (YO-IFOS), Research Study Group, 75000 Paris, France; (A.M.-S.); (F.A.); (C.M.C.-E.); (L.A.V.); (J.R.L.)
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Jerome R. Lechien
- Young-Otolaryngologists of the International Federation of Oto-Rhino-Laryngological Societies (YO-IFOS), Research Study Group, 75000 Paris, France; (A.M.-S.); (F.A.); (C.M.C.-E.); (L.A.V.); (J.R.L.)
- Department of Otolaryngology, Polyclinique de Poitiers, Elsan Hospital, 86000 Poitiers, France
- Department of Otolaryngology—Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 91190 Paris, France
- Department of Human Anatomy and Experimental Oncology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium
- Department of Otolaryngology—Head & Neck Surgery, CHU Saint-Pierre (CHU de Bruxelles), 1000 Brussels, Belgium
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Barsties V Latoszek B, Watts CR, Hetjens S, Neumann K. The Efficacy of Different Voice Treatments for Vocal Fold Polyps: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12103451. [PMID: 37240557 DOI: 10.3390/jcm12103451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Vocal fold polyps (VFP) are a common cause of voice disorders and laryngeal discomfort. They are usually treated by behavioral voice therapy (VT) or phonosurgery, or a combination (CT) of both. However, the superiority of either of these treatments has not been clearly established. METHODS Three databases were searched from inception to October 2022 and a manual search was performed. All clinical trials of VFP treatment were included that reported at least auditory-perceptual judgment, aerodynamics, acoustics, and the patient-perceived handicap. RESULTS We identified 31 eligible studies (VT: n = 47-194; phonosurgery: n = 404-1039; CT: n = 237-350). All treatment approaches were highly effective, with large effect sizes (d > 0.8) and significant improvements in almost all voice parameters (p-values < 0.05). Phonosurgery reduced roughness and NHR, and the emotional and functional subscales of the VHI-30 were the most compared to behavioral voice therapy and combined treatment (p-values < 0.001). Combined treatment improved hoarseness, jitter, shimmer, MPT, and the physical subscale of the VHI-30 more than phonosurgery and behavioral voice therapy (p-values < 0.001). CONCLUSIONS All three treatment approaches were effective in eliminating vocal fold polyps or their negative sequelae, with phonosurgery and combined treatment providing the greatest improvement. These results may inform future treatment decisions for patients with vocal fold polyps.
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Affiliation(s)
- Ben Barsties V Latoszek
- Speech-Language Pathology, SRH University of Applied Health Sciences, 40210 Düsseldorf, Germany
| | - Christopher R Watts
- Harris College of Nursing & Health Sciences, Texas Christian University, Fort Worth, TX 76109, USA
| | - Svetlana Hetjens
- Department for Medical Statistics and Biomathematics, Medical Faculty Mannheim, University of Heidelberg, 68165 Mannheim, Germany
| | - Katrin Neumann
- Department of Phoniatrics and Pediatric Audiology, University Hospital Münster, University of Münster, 48149 Münster, Germany
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Abi Zeid Daou C, Ghanem A, Hosri J, Abou Raji Feghali P, Hamdan AL. Office-Based Laser Therapy in Vocal Fold Polyps: A Systematic Review and Meta-Analysis. J Voice 2023:S0892-1997(23)00095-4. [PMID: 37003865 DOI: 10.1016/j.jvoice.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/02/2023] [Accepted: 03/02/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVES To analyze voice outcomes and lesion regression in patients with vocal fold polyps treated in-office using lasers. STUDY DESIGN Systematic review and meta-analysis. METHODS The search was performed in the Medline, Embase, and Cochrane databases using the preferred reporting items for systematic review and meta-analyses framework. There were no limitations to the year of publication and the search included studies looking at voice outcomes and lesion evolution of in-office laser treatment for vocal fold polyps measured through voice-handicap index, GRB, acoustic analysis or aerodynamics measures. Risk of bias was assessed using Cochrane's ROBINS-I tool for observational studies. Data analysis was performed SPSS software with a significance level of 5%. RESULTS We identified 167 articles, 10 of which met the inclusion criteria and were analyzed. The total number of participants was 242. Meta-analysis showed significant improvement in voice handicap index-10 scores (95% CI, [0.86; 1.45]) and decrease in GRB score (95% CI, [1.09; 4.13]) after in-office laser therapy. It also showed significant improvement in percent shimmer (95% CI, [0.26; 1.01]), and significant increase in maximum phonation time (95% CI, [-0.92; -0.18]). CONCLUSIONS Laser therapy an outpatient office setting is a reliable alternative to classical phono-microsurgery. Results show Office-based laser therapy of vocal fold polyps results in a significant improvement in subjective voice outcomes measures. This subjective improvement in voice quality is associated with partial or complete disease regression on laryngeal examination and an increase in maximum phonation time. Ovlaryngeal examination in patients with polyps treated with in-office laser.
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Affiliation(s)
- Christophe Abi Zeid Daou
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Anthony Ghanem
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon.
| | - Jad Hosri
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Patrick Abou Raji Feghali
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Abdul-Latif Hamdan
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon.
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Application of Thulium Laser as Office-based Procedure in Patients With Vocal Fold Polyps. J Voice 2020; 34:140-144. [DOI: 10.1016/j.jvoice.2018.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/15/2018] [Accepted: 08/27/2018] [Indexed: 11/23/2022]
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Hamdan AL, Khalifee E, Jaffal H, Abi Akl PR. Laser Partial Arytenoidectomy as an Office Procedure. EAR, NOSE & THROAT JOURNAL 2019; 98:217-219. [PMID: 30913917 DOI: 10.1177/0145561319836427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Bilateral vocal fold paralysis is a disabling condition that results in airway symptoms, dysphonia, and sometimes difficulty swallowing. Various types of glottal widening procedures have been described in the literature, all of which are performed in the operating room under general anesthesia. The aim is to report laser partial arytenoidectomy as an office-based treatment modality in a patient with bilateral vocal fold paralysis. Using Thulium laser fiber introduced through the working channel of fiberoptic nasopharyngoscope, a posterior cordectomy followed by resection of the vocal process of the right arytenoid was performed. The laser was used in a pulsed mode, power range 3.5 to 4.5 W, duration 70 to 300 milliseconds, repetition 2 to 4 Hz, and aiming beam 65%. The procedure was well tolerated and the patient was successfully decannulated 3 weeks later. Unsedated office-based laser arytenoidectomy might be considered a safe alternative to the commonly practiced glottal widening procedures in patients with a preexisting tracheotomy.
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Affiliation(s)
- Abdul-Latif Hamdan
- 1 Department of Otolaryngology-Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Elie Khalifee
- 1 Department of Otolaryngology-Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hussein Jaffal
- 1 Department of Otolaryngology-Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Pierre Richard Abi Akl
- 1 Department of Otolaryngology-Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
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Araki K, Tomifuji M, Uno K, Suzuki H, Tanaka Y, Tanaka S, Kimura E, Shiotani A. Feasibility of transnasal flexible carbon dioxide laser surgery for laryngopharyngeal lesions. Auris Nasus Larynx 2019; 46:772-778. [PMID: 30765273 DOI: 10.1016/j.anl.2019.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 01/03/2019] [Accepted: 01/23/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The fiber-guided carbon dioxide (CO2) laser is a useful device for laryngopharyngeal surgery. The flexible CO2 wave-guide laser has been developed and commercially available for several years. However, the transnasal use of CO2 flexible wave-guided laser surgery through the instrument channel of a flexible endoscope (CO2 TNFLS) is not permitted in Japan. This feasibility study aimed to assess the value and the safety of an in-office CO2 TNFLS procedure. METHODS Patients with small laryngopharyngeal diseases were enrolled from June 2015. Eligible patients had indications with lesions generally localized superficial lesions such as the benign tumor, leukoplakia, and premalignant lesion-like carcinoma in situ (CIS). Patients were locally well anesthetized using xylocaine. After removing as much of the lesion(s) as possible with flexible forceps, the remainder of the lesions were evaporated using CO2 TNFLS through the instrument channel of a flexible endoscope under local anesthesia. RESULTS Eighteen surgeries involving 13 patients, including 9 papilloma (7 recurrent respiratory papilloma [RRP]), 2 carcinoma in situ, 1 leukoplakia, and 1 large epiglottic cyst), were performed. Four patients with RRP required multiple surgeries. Except for 3 patients with RRP, all patients achieved disease control without additional intervention. All procedures were completed with no severe adverse events. CONCLUSION Office-based CO2 TNFLS is safe and feasible for patients with laryngopharyngeal pathologies. It is especially valuable for RRP patients with small lesions to avoid surgery under general anesthesia.
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Affiliation(s)
- Koji Araki
- Department of Otolaryngology - Head & Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
| | - Masayuki Tomifuji
- Department of Otolaryngology - Head & Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Kosuke Uno
- Department of Otolaryngology - Head & Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Hiroshi Suzuki
- Department of Otolaryngology - Head & Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Yuya Tanaka
- Department of Otolaryngology - Head & Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Shingo Tanaka
- Department of Otolaryngology - Head & Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Eiko Kimura
- Department of Otolaryngology - Head & Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Akihiro Shiotani
- Department of Otolaryngology - Head & Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
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10
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Shoffel‐Havakuk H, Sadoughi B, Sulica L, Johns MM. In‐office procedures for the treatment of benign vocal fold lesions in the awake patient: A contemporary review. Laryngoscope 2018; 129:2131-2138. [DOI: 10.1002/lary.27731] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Hagit Shoffel‐Havakuk
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Sackler Faculty of MedicineTel‐Aviv University Israel
| | - Babak Sadoughi
- Sean Parker Institute for the Voice, Department of Otolaryngology–Head and Neck SurgeryWeill Cornell Medical College/New York Presbyterian Hospital New York New York
| | - Lucian Sulica
- Sean Parker Institute for the Voice, Department of Otolaryngology–Head and Neck SurgeryWeill Cornell Medical College/New York Presbyterian Hospital New York New York
| | - Michael M. Johns
- USC Voice Center, Department of Otolaryngology Head and Neck SurgeryUniversity of Southern California Los Angeles California U.S.A
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11
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Kim JH, Hwang HJ, Kim JH, Kang MS, Choi HS, Byeon HK. Secondary submucosal vocal cyst following pulsed dye laser application for sulcus vocalis. Acta Otolaryngol 2017; 137:563-566. [PMID: 27879157 DOI: 10.1080/00016489.2016.1255991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONCLUSION Submucosal vocal cyst can occur as a distinct long-term sequelae following pulsed dye laser (PDL) application for sulcus vocalis. It is recommended that the cyst lesion should be surgically removed for treatment. Optimal and precise irradiation of PDL is considered important to avoid the development of a such complication. OBJECTIVE After several years of clinical practice and an extended period of follow-up of the patients who received PDL application in treating sulcus vocalis, the authors have encountered several cases of secondary submucosal vocal cyst development. Therefore, this study aims to investigate this late complication following PDL laryngeal surgery. METHODS Patients who developed secondary submucosal vocal cyst after last PDL laryngeal surgery between March 2008 and January 2016 were analyzed after retrospectively reviewing clinical and operative data. RESULTS There were a total 11 patients who had been identified as presenting secondary submucosal vocal cyst among 186 patients who underwent PDL laryngeal surgery (5.9% incidence). All five patients who received surgery showed complete resolution and were free of symptoms. The remaining six patients were closely observed with conservative measures, with only one patient who showed resolution of the cyst.
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Affiliation(s)
- Joo Hyun Kim
- Department of Otorhinolaryngology, Institute of Logopedics and Phoniatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Jin Hwang
- Department of Otorhinolaryngology, Institute of Logopedics and Phoniatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Hyung Kim
- Department of Otorhinolaryngology, Institute of Logopedics and Phoniatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Seok Kang
- Department of Otorhinolaryngology, Institute of Logopedics and Phoniatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hong-Shik Choi
- Department of Otorhinolaryngology, Institute of Logopedics and Phoniatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyung Kwon Byeon
- Department of Otorhinolaryngology, Institute of Logopedics and Phoniatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
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Treatment for Vocal Polyps: Lips and Tongue Trill. J Voice 2017; 31:252.e27-252.e36. [DOI: 10.1016/j.jvoice.2016.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/05/2016] [Accepted: 07/07/2016] [Indexed: 11/22/2022]
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13
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Del Signore AG, Shah RN, Gupta N, Altman KW, Woo P. Complications and Failures of Office-Based Endoscopic Angiolytic Laser Surgery Treatment. J Voice 2016; 30:744-750. [DOI: 10.1016/j.jvoice.2015.08.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 08/31/2015] [Indexed: 10/20/2022]
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14
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Zhuge P, You H, Wang H, Zhang Y, Du H. An Analysis of the Effects of Voice Therapy on Patients With Early Vocal Fold Polyps. J Voice 2016; 30:698-704. [DOI: 10.1016/j.jvoice.2015.08.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/19/2015] [Indexed: 11/29/2022]
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15
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Surgical Management of Phonotraumatic Lesions: Current Techniques. CURRENT OTORHINOLARYNGOLOGY REPORTS 2016. [DOI: 10.1007/s40136-016-0122-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Chang JW, Park AY, Byeon HK, Choi HS. Use of pulsed dye laser treatments in patients with vocal fold mucosal bridges with sulcus vocalis - our experience of five cases. Clin Otolaryngol 2016; 42:715-719. [PMID: 26751135 DOI: 10.1111/coa.12618] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2015] [Indexed: 12/01/2022]
Affiliation(s)
- J W Chang
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Korea
| | - A Y Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - H K Byeon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.,Gangnam Severance Hospital, Institution of Logopedics & Phoniatrics, Yonsei University College of Medicine, Seoul, Korea
| | - H-S Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.,Gangnam Severance Hospital, Institution of Logopedics & Phoniatrics, Yonsei University College of Medicine, Seoul, Korea
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Treatment of Hemorrhagic Vocal Polyps by Pulsed Dye Laser-Assisted Laryngomicrosurgery. BIOMED RESEARCH INTERNATIONAL 2015; 2015:820654. [PMID: 26557700 PMCID: PMC4628719 DOI: 10.1155/2015/820654] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/19/2015] [Accepted: 03/19/2015] [Indexed: 11/24/2022]
Abstract
Objective. Conventional surgical techniques of laryngomicrosurgery (LMS) on hemorrhagic vocal polyps are often difficult due to obscuration of the surgical field by inadvertent bleeding from the lesion, and there are often significant amounts of mucosal epithelium loss. Here, we introduce our surgical technique using pulsed dye laser (PDL), which can effectively resect the polyp with vocal fold mucosa preservation. Methods. Patients who were diagnosed with hemorrhagic vocal polyp and who were surgically managed using PDL from March 2013 to October 2014 were retrospectively reviewed. Preoperative and postoperative clinical outcomes and surgical findings were evaluated. Results. A total of 39 patients were treated with PDL-assisted enucleation LMS. The average age was 43.7 years (range 20–73), and there were 20 males and 19 females (17 professional voice users). In all cases, the hemorrhagic polyp was successfully enucleated after application of PDL, thereby preserving the overlying epithelium. Postoperative voice outcomes were favorable with clear preservation of the vocal fold mucosal wave. Conclusion. PDL-assisted enucleation LMS for the treatment of hemorrhagic vocal polyps can be a safe and effective surgical technique. It can be considered a promising treatment option for hemorrhagic vocal polyps.
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Comparison of vocal outcomes after angiolytic laser surgery and microflap surgery for vocal polyps. Auris Nasus Larynx 2015; 42:453-7. [PMID: 25933587 DOI: 10.1016/j.anl.2015.03.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 02/16/2015] [Accepted: 03/20/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The microflap technique is a standard procedure for the treatment of vocal fold polyps. Angiolytic laser surgery carried out under topical anesthesia is an alternative method for vocal polyp removal. However, it is not clear whether angiolytic laser surgery has the same effects on vocal outcomes as the microflap technique because of a lack of studies comparing both procedures. In the current study, vocal outcomes after both procedures were compared to clarify the effects of angiolytic laser surgery for vocal polyp removal. METHODS Vocal outcomes were reviewed for patients who underwent angiolytic laser surgery (n=20, laser group) or microflap surgery (n=34, microflap group) for vocal polyp removal. The data analyzed included patient and lesion characteristics, number of surgeries required for complete resolution, and aerodynamic and acoustic examinations before and after surgery. RESULTS In the laser surgery group, complete resolution of the lesion was achieved with a single procedure in 17 cases (85%) and with two procedures in 3 cases (15%). Postoperative aerodynamic and acoustic parameters demonstrated significant improvement compared to preoperative parameters in both the laser surgery group and the microflap surgery group. There were no significant differences in any postoperative aerodynamic and acoustic parameters between the two groups. CONCLUSION The current retrospective study demonstrated that angiolytic laser surgery achieved complete resolution of vocal polyps within two procedures. Postoperative effects on aerodynamic and acoustic functions were similar to those after microflap surgery.
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Comparison of Effects on Voice of Diode Laser and Cold Knife Microlaryngology Techniques for Vocal Fold Polyps. J Voice 2014; 28:387-92. [DOI: 10.1016/j.jvoice.2013.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 10/23/2013] [Indexed: 11/24/2022]
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21
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Current Opinion in Otolaryngology & Head & Neck Surgery. Current world literature. Curr Opin Otolaryngol Head Neck Surg 2009; 17:494-8. [PMID: 19907224 DOI: 10.1097/moo.0b013e32833385d7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rosen CA, Amin MR, Sulica L, Simpson CB, Merati AL, Courey MS, Johns MM, Postma GN. Advances in office-based diagnosis and treatment in laryngology. Laryngoscope 2009; 119 Suppl 2:S185-212. [DOI: 10.1002/lary.20712] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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