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Office-based potassium titanyl phosphate laser-assisted endoscopic vocal polypectomy.
JAMA Otolaryngol Head Neck Surg. 2013 Jun; 139(6):610-6.JO

Abstract

IMPORTANCE

Vocal polyps are common exophytic laryngeal lesions that usually necessitate microscopic laryngeal surgery under general anesthesia. Office-based indirect laryngoscopic procedures provide an alternative management option and can be performed comfortably under flexible endoscopic guidance. Combining angiolytic potassium titanyl phosphate (KTP) laser treatment and flexible endoscopic polypectomy should alleviate the risks of surgery under general anesthesia and expedite lesion regression.

OBJECTIVES

To combine angiolytic KTP laser treatment and endoscopic polyp removal and to evaluate the clinical applicability, treatment outcomes, and adverse effects of office-based KTP laser-assisted vocal polypectomy.

DESIGN

Case series of KTP laser treatment (n = 16) and KTP laser-assisted polypectomy (n = 20). Patients underwent pretreatment and 2- and 6-week posttreatment evaluation with videolaryngostroboscopy (VLS), maximal phonation time, and a 10-item voice handicap index. Perceptual (GRB [grade, roughness, breathiness] scale) and acoustic analyses were performed before and 6 weeks after treatment.

SETTING

Tertiary teaching hospital.

PARTICIPANTS

Thirty-six outpatients with unilateral hemorrhagic vocal polyps.

INTERVENTIONS

Under local anesthesia, the KTP laser fiber was passed through the working channel of the flexible laryngoscope to photocoagulate the microvasculature of the polyp in all patients. Removal of coagulated vocal polyp using a flexible, endoscopic, blunt-ended grasping forceps immediately after KTP laser application was performed in the polypectomy group.

MAIN OUTCOMES AND MEASURES

Results of VLS, maximal phonation time, 10-item voice handicap index, and perceptual and acoustic analyses.

RESULTS

Six weeks after KTP laser treatment with and without polypectomy, 19 and 12 patients, respectively, experienced complete recovery and much improvement of mucosal wave. Maximal phonation time and the voice handicap index improved significantly 2 weeks after KTP laser with polypectomy (P < .01), whereas significant improvements were noted 6 weeks postoperatively in both treatment groups (P < .05). Acoustic and perceptual analyses also revealed significant improvements in both study groups (P < .05). During follow-up, we did not notice significant adverse effects.

CONCLUSIONS AND RELEVANCE

Potassium titanyl phosphate laser-assisted vocal polypectomy is a safe, practical, and effective alternative option to treat hemorrhagic vocal polyps in the outpatient department, offering comparable but earlier therapeutic effects than KTP laser alone.

Authors+Show Affiliations

Department of Otolaryngology–Head and Neck Surgery, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, Banciao District, New Taipei City, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23787420

Citation

Wang, Chi-Te, et al. "Office-based Potassium Titanyl Phosphate Laser-assisted Endoscopic Vocal Polypectomy." JAMA Otolaryngology-- Head & Neck Surgery, vol. 139, no. 6, 2013, pp. 610-6.
Wang CT, Huang TW, Liao LJ, et al. Office-based potassium titanyl phosphate laser-assisted endoscopic vocal polypectomy. JAMA Otolaryngol Head Neck Surg. 2013;139(6):610-6.
Wang, C. T., Huang, T. W., Liao, L. J., Lo, W. C., Lai, M. S., & Cheng, P. W. (2013). Office-based potassium titanyl phosphate laser-assisted endoscopic vocal polypectomy. JAMA Otolaryngology-- Head & Neck Surgery, 139(6), 610-6. https://doi.org/10.1001/jamaoto.2013.3052
Wang CT, et al. Office-based Potassium Titanyl Phosphate Laser-assisted Endoscopic Vocal Polypectomy. JAMA Otolaryngol Head Neck Surg. 2013;139(6):610-6. PubMed PMID: 23787420.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Office-based potassium titanyl phosphate laser-assisted endoscopic vocal polypectomy. AU - Wang,Chi-Te, AU - Huang,Tsung-Wei, AU - Liao,Li-Jen, AU - Lo,Wu-Chia, AU - Lai,Mei-Shu, AU - Cheng,Po-Wen, PY - 2013/6/22/entrez PY - 2013/6/22/pubmed PY - 2013/8/28/medline SP - 610 EP - 6 JF - JAMA otolaryngology-- head & neck surgery JO - JAMA Otolaryngol Head Neck Surg VL - 139 IS - 6 N2 - IMPORTANCE: Vocal polyps are common exophytic laryngeal lesions that usually necessitate microscopic laryngeal surgery under general anesthesia. Office-based indirect laryngoscopic procedures provide an alternative management option and can be performed comfortably under flexible endoscopic guidance. Combining angiolytic potassium titanyl phosphate (KTP) laser treatment and flexible endoscopic polypectomy should alleviate the risks of surgery under general anesthesia and expedite lesion regression. OBJECTIVES: To combine angiolytic KTP laser treatment and endoscopic polyp removal and to evaluate the clinical applicability, treatment outcomes, and adverse effects of office-based KTP laser-assisted vocal polypectomy. DESIGN: Case series of KTP laser treatment (n = 16) and KTP laser-assisted polypectomy (n = 20). Patients underwent pretreatment and 2- and 6-week posttreatment evaluation with videolaryngostroboscopy (VLS), maximal phonation time, and a 10-item voice handicap index. Perceptual (GRB [grade, roughness, breathiness] scale) and acoustic analyses were performed before and 6 weeks after treatment. SETTING: Tertiary teaching hospital. PARTICIPANTS: Thirty-six outpatients with unilateral hemorrhagic vocal polyps. INTERVENTIONS: Under local anesthesia, the KTP laser fiber was passed through the working channel of the flexible laryngoscope to photocoagulate the microvasculature of the polyp in all patients. Removal of coagulated vocal polyp using a flexible, endoscopic, blunt-ended grasping forceps immediately after KTP laser application was performed in the polypectomy group. MAIN OUTCOMES AND MEASURES: Results of VLS, maximal phonation time, 10-item voice handicap index, and perceptual and acoustic analyses. RESULTS: Six weeks after KTP laser treatment with and without polypectomy, 19 and 12 patients, respectively, experienced complete recovery and much improvement of mucosal wave. Maximal phonation time and the voice handicap index improved significantly 2 weeks after KTP laser with polypectomy (P < .01), whereas significant improvements were noted 6 weeks postoperatively in both treatment groups (P < .05). Acoustic and perceptual analyses also revealed significant improvements in both study groups (P < .05). During follow-up, we did not notice significant adverse effects. CONCLUSIONS AND RELEVANCE: Potassium titanyl phosphate laser-assisted vocal polypectomy is a safe, practical, and effective alternative option to treat hemorrhagic vocal polyps in the outpatient department, offering comparable but earlier therapeutic effects than KTP laser alone. SN - 2168-619X UR - https://www.unboundmedicine.com/medline/citation/23787420/Office_based_potassium_titanyl_phosphate_laser_assisted_endoscopic_vocal_polypectomy_ L2 - https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/jamaoto.2013.3052 DB - PRIME DP - Unbound Medicine ER -