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Office-based CO2 laser surgery for benign and premalignant laryngeal lesions.
Laryngoscope. 2020 06; 130(6):1503-1507.L

Abstract

OBJECTIVE

Patients with laryngeal pathology are often treated with CO2 laser surgery, usually in the operating room under general anesthesia. Although office-based laser surgery using several other laser types has been investigated, prospective studies on office-based CO2 laser surgery are scarce. Our goal was to investigate the feasibility of office-based CO2 laser surgery for benign and premalignant laryngeal pathology by analyzing completion rate, safety, effect on voice quality, and success rate (i.e., no residual or recurrent disease).

METHODS

A prospective cohort study was performed of 30 consecutive procedures. Inclusion started in June 2016 and was completed in August 2018. Adult patients with clinically benign or premalignant laryngeal lesions who could not undergo transoral laser microsurgery in the operating room under general anesthesia were included. Reasons were either contraindications for general anesthesia, previously failed therapeutic laryngoscopy under general anesthesia, and preference of a procedure under topical anesthesia by the patient. The mean follow-up was 9 months.

RESULTS

Thirty procedures were performed in 27 patients (24 males) with an average age of 62 years. Twenty-nine (97%) procedures were fully completed without complications. The mean preoperative Voice Handicap Index (VHI) score (VHI 44) significantly decreased 2 months (VHI 28, P = 0.032) and 6 months (VHI 14, P < 0.001) after the procedure. Almost two-thirds of patients showed no residual or recurrent disease at their follow-up visits.

CONCLUSION

Office-based CO2 laser surgery is a feasible and safe procedure that results in significant voice-quality improvement. Almost two-thirds of patients did not require further treatment.

LEVEL OF EVIDENCE

2 Laryngoscope, 130:1503-1507, 2020.

Authors+Show Affiliations

Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.

Pub Type(s)

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

Language

eng

PubMed ID

31498454

Citation

Wellenstein, David J., et al. "Office-based CO2 Laser Surgery for Benign and Premalignant Laryngeal Lesions." The Laryngoscope, vol. 130, no. 6, 2020, pp. 1503-1507.
Wellenstein DJ, Honings J, Schimberg AS, et al. Office-based CO2 laser surgery for benign and premalignant laryngeal lesions. Laryngoscope. 2020;130(6):1503-1507.
Wellenstein, D. J., Honings, J., Schimberg, A. S., Schutte, H. W., Herruer, J. M., van den Hoogen, F. J. A., Takes, R. P., & van den Broek, G. B. (2020). Office-based CO2 laser surgery for benign and premalignant laryngeal lesions. The Laryngoscope, 130(6), 1503-1507. https://doi.org/10.1002/lary.28278
Wellenstein DJ, et al. Office-based CO2 Laser Surgery for Benign and Premalignant Laryngeal Lesions. Laryngoscope. 2020;130(6):1503-1507. PubMed PMID: 31498454.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Office-based CO2 laser surgery for benign and premalignant laryngeal lesions. AU - Wellenstein,David J, AU - Honings,Jimmie, AU - Schimberg,Anouk S, AU - Schutte,Henrieke W, AU - Herruer,Jasmijn M, AU - van den Hoogen,Frank J A, AU - Takes,Robert P, AU - van den Broek,Guido B, Y1 - 2019/09/09/ PY - 2019/06/12/received PY - 2019/08/19/accepted PY - 2019/9/10/pubmed PY - 2020/9/25/medline PY - 2019/9/10/entrez KW - CO2 laser KW - Laser surgery KW - larynx KW - office-based KW - topical anesthesia SP - 1503 EP - 1507 JF - The Laryngoscope JO - Laryngoscope VL - 130 IS - 6 N2 - OBJECTIVE: Patients with laryngeal pathology are often treated with CO2 laser surgery, usually in the operating room under general anesthesia. Although office-based laser surgery using several other laser types has been investigated, prospective studies on office-based CO2 laser surgery are scarce. Our goal was to investigate the feasibility of office-based CO2 laser surgery for benign and premalignant laryngeal pathology by analyzing completion rate, safety, effect on voice quality, and success rate (i.e., no residual or recurrent disease). METHODS: A prospective cohort study was performed of 30 consecutive procedures. Inclusion started in June 2016 and was completed in August 2018. Adult patients with clinically benign or premalignant laryngeal lesions who could not undergo transoral laser microsurgery in the operating room under general anesthesia were included. Reasons were either contraindications for general anesthesia, previously failed therapeutic laryngoscopy under general anesthesia, and preference of a procedure under topical anesthesia by the patient. The mean follow-up was 9 months. RESULTS: Thirty procedures were performed in 27 patients (24 males) with an average age of 62 years. Twenty-nine (97%) procedures were fully completed without complications. The mean preoperative Voice Handicap Index (VHI) score (VHI 44) significantly decreased 2 months (VHI 28, P = 0.032) and 6 months (VHI 14, P < 0.001) after the procedure. Almost two-thirds of patients showed no residual or recurrent disease at their follow-up visits. CONCLUSION: Office-based CO2 laser surgery is a feasible and safe procedure that results in significant voice-quality improvement. Almost two-thirds of patients did not require further treatment. LEVEL OF EVIDENCE: 2 Laryngoscope, 130:1503-1507, 2020. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/31498454/Office_based_CO2_laser_surgery_for_benign_and_premalignant_laryngeal_lesions_ L2 - https://doi.org/10.1002/lary.28278 DB - PRIME DP - Unbound Medicine ER -