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Mao W, Zhen R, Zhang F, Wu X, Ma J, Zhao X, Fang R, He P, Wei C. Office-based 532-nm KTP laser as a therapeutic modality for recurrent laryngeal papillomatosis: efficacy and relative factors. Lasers Med Sci 2023; 38:119. [PMID: 37154975 DOI: 10.1007/s10103-023-03763-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 04/05/2023] [Indexed: 05/10/2023]
Abstract
This study aims to investigate the efficacy of office-based potassium-titanyl-phosphate (KTP) 532-nm laser in the management of recurrent laryngeal papillomatosis (RLP) following other treatments. A retrospective assessment was performed on 55 patients in 259 cases of RLP between 2012 and 2019. Derkay scores were obtained for all patients who underwent 532-nm KTP laser procedure (6 W of power with a continuous output mode) prior to treatment and after treatment. Analysis of parameters is based on the distribution characteristics of data. An ordinal logistic regression was also performed. Patients received a median of 3 (range 1-24) office-based KTP laser treatments. Among them, 96.36% (53 patients) were previously on cold steel equipment, CO2 laser, or microdebrider treatment under general anesthesia, and all previous treatments on them had failed. One patient progressed to invasive cancer, so he was excluded from the following analyses. After final KTP treatment, 36 patients (66.67%) received complete resolution with follow-up time ranging from 12.9 to 80.53 months (median 55.54 months). Results of subjective voice-quality indicators such as VHI-30 and GRBAS all improved greatly at the last follow-up. The initial Derkay scores and treatment intervals were found to be predictive of complete lesion remission. Arytenoid involvement may also correlate with lesion resolution. Serial office-based KTP treatment is an effective option for RLP patients, with ideal disease control and voice quality preservation. KTP laser therapy should be repeated with an interval of 1 month from the beginning of treatment until the lesion has been evaluated and subsided. Non-bulk or scattered laryngeal papilloma is an appropriate indication for KTP laser treatment.
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Affiliation(s)
- Wenjing Mao
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, 83 Fenyang Rd., Shanghai, 200031, China
| | - Ruiqing Zhen
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, 83 Fenyang Rd., Shanghai, 200031, China
| | - Fan Zhang
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, 83 Fenyang Rd., Shanghai, 200031, China
| | - Xiufa Wu
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, 83 Fenyang Rd., Shanghai, 200031, China
| | - Jingru Ma
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, 83 Fenyang Rd., Shanghai, 200031, China
| | - Xiaoyun Zhao
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, 83 Fenyang Rd., Shanghai, 200031, China
| | - Rui Fang
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, 83 Fenyang Rd., Shanghai, 200031, China
| | - Peijie He
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, 83 Fenyang Rd., Shanghai, 200031, China.
| | - Chunsheng Wei
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, 83 Fenyang Rd., Shanghai, 200031, China.
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Abstract
With fiber-based lasers that may be passed via the working channel of a flexible laryngoscope, in-office laser laryngeal surgery has become possible. The potassium-titanyl-phosphate laser has several features that make it ideal for laryngeal surgery, and it is now the laser of choice for in-office management of a variety of laryngeal lesions. Its applications have expanded significantly since its introduction, with reports of new indications continuing to appear in the literature. This article provides a comprehensive review of the indications and technical details of in-office potassium-titanyl-phosphate laser laryngeal surgery, and a summary of the existing literature regarding outcomes of these procedures.
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Tracy LF, Hron TA, Van Stan JH, Burns JA. Wound healing after transoral angiolytic laser surgery for early glottic carcinoma. Laryngoscope 2018; 129:435-440. [PMID: 30194756 DOI: 10.1002/lary.27283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Wound healing after transoral angiolytic laser surgery for early glottic carcinoma was analyzed to identify factors influencing healing and clinical significance of persistent granulation tissue. STUDY DESIGN Retrospective review. METHODS A retrospective review of 100 consecutive patients undergoing endoscopic angiolytic laser surgery for T1 and T2 glottic carcinoma was performed. Patients with prior radiation or incomplete data were excluded. Postoperative endoscopic images were analyzed for time to healing, size and location of wound, and presence of granulation tissue. Three blinded, independent raters graded wound appearance and presence of granulation tissue. RESULTS Seventy-nine patients healed without need for intervention at a median of 3.5 months. Two patients had office-based ablation of granulation without biopsy and healed. The remaining 19 patients had biopsy for granulation tissue. Wounds that underwent biopsy at >3 months were more likely to contain carcinoma (5/6 patients, 83%) than wounds that were biopsied <3 months (2/13 patients, 15%) (P = .004). Presence of granulation significantly correlated with resection involving anterior commissure (P = .01), > 75%vocal fold length (P = .006), and depth into muscle (P = .001). Delayed healing (>3 months) correlated with T2b tumors (P = .02), depth into ligament (P = .002) and anterior commissure involvement (P = .04). T1a carcinomas more commonly healed in <3 months (P = .005). CONCLUSIONS Many vocal fold wounds heal completely within 3.5 months after angiolytic laser surgery for early glottic carcinoma. Larger and deeper wounds are more likely to heal with granulation tissue. Granulation can resolve without surgical intervention; however, granulation present > 3 months warrants biopsy due to increased risk of malignancy. LEVEL OF EVIDENCE 4 Laryngoscope, 129:435-440, 2019.
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Affiliation(s)
- Lauren F Tracy
- Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Tiffiny A Hron
- Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Jarrad H Van Stan
- Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.,Department of Communication Sciences and Disorders, Massachusetts General Hospital Institute of Health Professions, Charlestown, Massachusetts, U.S.A
| | - James A Burns
- Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
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Helman SN, Pitman MJ. Office-based 532-Nanometer pulsed potassium-titanyl-phosphate laser for marsupialization of laryngeal and vallecular mucoceles. Laryngoscope 2016; 127:1116-1118. [PMID: 27435457 DOI: 10.1002/lary.26173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/22/2016] [Accepted: 06/09/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS Many laryngopharyngeal disorders are effectively managed in the office. Herein, an in-office method utilizing the 532-nm potassium-titanyl-phosphate (KTP) laser for the treatment of benign laryngeal and vallecular mucoceles is described. STUDY DESIGN Retrospective case review. METHODS A review was performed of patients who had their vallecular or laryngeal mucoceles marsupialized in the office using KTP laser. RESULTS Outcomes included long-term follow-up laryngoscopy for evidence of recurrence, significant intraprocedural complications, tolerance of the procedure, final pathology of the specimen, and resolution of symptoms. CONCLUSIONS In-office KTP marsupialization of laryngeal and vallecular mucoceles is effective and well tolerated, with no episodes of recurrence to date. LEVEL OF EVIDENCE 4. Laryngoscope, 127:1116-1118, 2017.
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Affiliation(s)
- Samuel N Helman
- Department of Otolaryngology/Head and Neck Surgery, New York Eye and Ear Infirmary-Mount Sinai Health System, New York, New York, U.S.A
| | - Michael J Pitman
- Voice and Swallowing Institute, Department of Otolaryngology/Head and Neck Surgery, Columbia University Medical Center, New York, New York, U.S.A
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Bostanci Y, Kazzazi A, Djavan B. Laser prostatectomy: holmium laser enucleation and photoselective laser vaporization of the prostate. Rev Urol 2013; 15:1-10. [PMID: 23671400 PMCID: PMC3651537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Historically, transurethral resection of the prostate has been the gold standard for the treatment of benign prostatic hyperplasia (BPH). Laser technology has been used to treat BPH for > 15 years. Over the past decade, it has gained wide acceptance by experienced urologists. This review provides an evidence-based update on laser surgery for BPH with a focus on photoselective laser vaporization and holmium laser enucleation of the prostate surgeries and assesses the safety, efficacy, and durability of these techniques.
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Affiliation(s)
- Yakup Bostanci
- Department of Urology, New York University School of Medicine, New York, NY
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