Quantification of benign lesion regression as a function of 532-nm pulsed potassium titanyl phosphate laser parameter selection

• Published in: The Laryngoscope 2011-03, Vol.121 (3), p.590-595
• Main Authors: Mallur, Pavan S., Tajudeen, Bobby A., Aaronson, Nicole, Branski, Ryan C., Amin, Milan R.
• Format: Article
• Language: English
• Subjects: 532-nm potassium titanyl phosphate; Ambulatory Surgical Procedures; Biological and medical sciences; Carcinoma in Situ - surgery; Carcinoma, Squamous Cell - surgery; Cohort Studies; Cysts - surgery; Granuloma, Laryngeal - surgery; Hemorrhage - surgery; Humans; Laryngeal Diseases - surgery; Laryngeal Edema - surgery; Laryngeal Neoplasms - surgery; Laryngoscopy; larynx; Laser Therapy; Lasers, Solid-State - therapeutic use; lesion; Leukoplakia - surgery; Level of Evidence: 4; Medical sciences; Otorhinolaryngology. Stomatology; Polyps - surgery; Postoperative Complications - diagnosis; Potassium titanyl phosphate; Retrospective Studies; Stroboscopy; Treatment Outcome; vocal fold; voice
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.21354

Objectives/Hypothesis: Although the potassium titanyl phosphate (KTP) laser is versatile, the variability in laser parameters for laryngeal pathologies and the lack of clinical efficacy data remain problematic. We provide preliminary data regarding these parameters for benign lesion regression. In addition, we describe a novel method for the quantification of the effects of the KTP laser on vocal fold (VF) lesions. Study Design: Retrospective chart review. Methods: Images were captured from examinations before and after in‐office KTP treatment in patients with a range of benign lesions. Laser settings were noted for each patient. Imaging software was then used to calculate a ratio of lesion area to VF length. Ten percent of images were requantified to determine inter‐rater reliability. Results: Thirty‐two patients underwent 47 procedures for lesions including hemorrhagic polyp, nonhemorrhagic polyp, vocal process granuloma, Reinke's edema, cyst/pseudocyst, leukoplakia, and squamous cell carcinoma in situ. No statistically significant differences were observed with regard to the laser parameters used as a function of lesion type. Regardless, by 1 month following treatment, all lesions had significantly decreased in size, except nonhemorrhagic polyps. Similar data were obtained at 2‐month follow‐up. We then compared the pre‐KTP lesion size with the smallest lesion size quantified during the 1‐year follow‐up period. All lesions were significantly smaller, with the exception of Reinke's edema. Inter‐rater reliability was quite good. Conclusions: KTP laser effectively reduced VF lesion size, irrespective of the laser parameters used. In addition, our quantification method for lesion size appeared to be both viable and reliable. Laryngoscope, 2011