Tags

Type your tag names separated by a space and hit enter

Complications and Failures of Office-Based Endoscopic Angiolytic Laser Surgery Treatment.
J Voice. 2016 Nov; 30(6):744-750.JV

Abstract

OBJECTIVES/HYPOTHESIS

Although office-based laser surgery applications for benign and premalignant lesions of the larynx are appealing, there are scant data on their complications and failures. We review office-based angiolytic laser surgery in patients with benign laryngeal pathology for rates of complication and failure.

STUDY DESIGN

Retrospective chart review.

METHODS

Two hundred fifty-five patients who underwent in-office angiolytic laser surgery treatment over 4 years were reviewed. The criteria for complications and failures were based on postprocedure stroboscopy and clinical findings.

RESULTS

The majority of patients had unilateral disease, which included polyps (46%), leukoplakia (14%), papilloma (13%), scar (12%), and varix (11%). There were 382 laser treatments, of which 56% were by pulsed potassium titanyl phosphate laser. Average energy delivery was lesion specific, with papilloma receiving the most (mean 351 J) and varices receiving the least (mean 53 J) energy. Most in-office treatments were tolerated well. Four percent of patients had complications including stiffness, atrophy, and transient but prolonged hyperemia. Twenty-seven percent of patients required multiple laser treatments. Multiple treatments were more likely in papilloma and leukoplakia.

CONCLUSIONS

While in-office laser therapy for benign vocal fold lesions is appealing, repeated treatment due to incomplete resolution may be needed. Risks of transient and long-term complications are low but real. Patient selection and standardized laser energy parameters may help in decreasing complications and need for repeat procedures.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York 10029.Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina 27599.Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York 10029.Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas 77030.Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York 10029. Electronic address: peakwoo@peakwoo.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26433447

Citation

Del Signore, Anthony G., et al. "Complications and Failures of Office-Based Endoscopic Angiolytic Laser Surgery Treatment." Journal of Voice : Official Journal of the Voice Foundation, vol. 30, no. 6, 2016, pp. 744-750.
Del Signore AG, Shah RN, Gupta N, et al. Complications and Failures of Office-Based Endoscopic Angiolytic Laser Surgery Treatment. J Voice. 2016;30(6):744-750.
Del Signore, A. G., Shah, R. N., Gupta, N., Altman, K. W., & Woo, P. (2016). Complications and Failures of Office-Based Endoscopic Angiolytic Laser Surgery Treatment. Journal of Voice : Official Journal of the Voice Foundation, 30(6), 744-750. https://doi.org/10.1016/j.jvoice.2015.08.022
Del Signore AG, et al. Complications and Failures of Office-Based Endoscopic Angiolytic Laser Surgery Treatment. J Voice. 2016;30(6):744-750. PubMed PMID: 26433447.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complications and Failures of Office-Based Endoscopic Angiolytic Laser Surgery Treatment. AU - Del Signore,Anthony G, AU - Shah,Rupali N, AU - Gupta,Nikita, AU - Altman,Kenneth W, AU - Woo,Peak, PY - 2015/08/25/received PY - 2015/08/31/accepted PY - 2015/10/5/pubmed PY - 2017/5/10/medline PY - 2015/10/5/entrez KW - Angiolytic laser KW - Benign vocal fold lesions KW - Complications KW - Leukoplakia KW - Papilloma SP - 744 EP - 750 JF - Journal of voice : official journal of the Voice Foundation JO - J Voice VL - 30 IS - 6 N2 - OBJECTIVES/HYPOTHESIS: Although office-based laser surgery applications for benign and premalignant lesions of the larynx are appealing, there are scant data on their complications and failures. We review office-based angiolytic laser surgery in patients with benign laryngeal pathology for rates of complication and failure. STUDY DESIGN: Retrospective chart review. METHODS: Two hundred fifty-five patients who underwent in-office angiolytic laser surgery treatment over 4 years were reviewed. The criteria for complications and failures were based on postprocedure stroboscopy and clinical findings. RESULTS: The majority of patients had unilateral disease, which included polyps (46%), leukoplakia (14%), papilloma (13%), scar (12%), and varix (11%). There were 382 laser treatments, of which 56% were by pulsed potassium titanyl phosphate laser. Average energy delivery was lesion specific, with papilloma receiving the most (mean 351 J) and varices receiving the least (mean 53 J) energy. Most in-office treatments were tolerated well. Four percent of patients had complications including stiffness, atrophy, and transient but prolonged hyperemia. Twenty-seven percent of patients required multiple laser treatments. Multiple treatments were more likely in papilloma and leukoplakia. CONCLUSIONS: While in-office laser therapy for benign vocal fold lesions is appealing, repeated treatment due to incomplete resolution may be needed. Risks of transient and long-term complications are low but real. Patient selection and standardized laser energy parameters may help in decreasing complications and need for repeat procedures. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/26433447/Complications_and_Failures_of_Office_Based_Endoscopic_Angiolytic_Laser_Surgery_Treatment_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(15)00200-3 DB - PRIME DP - Unbound Medicine ER -