Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-27T09:34:08.020Z Has data issue: false hasContentIssue false

Value and utility of 532 nanometre pulsed potassium-titanyl-phosphate laser in endoscopic laryngeal surgery

Published online by Cambridge University Press:  27 November 2009

J A Burns*
Affiliation:
Department of Surgery, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
A D Friedman
Affiliation:
Department of Surgery, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
M J Lutch
Affiliation:
Department of Surgery, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
R E Hillman
Affiliation:
Department of Surgery, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA Department of Health Sciences and Technology, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
S M Zeitels
Affiliation:
Department of Surgery, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
*
Address for correspondence: Dr James A Burns, Assistant Professor, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, One Bowdoin Square, 11th Floor, Boston, MA 02114, USA. Fax: +1 617 726 0222 E-mail: burns.james@mgh.harvard.edu

Abstract

Objectives:

Recently, the 532 nm pulsed potassium-titanyl-phosphate laser has emerged as an effective angiolytic laser for treating mucosal lesions of the larynx in the operating theatre and clinic. We sought to assess the current impact of potassium-titanyl-phosphate laser on our laryngeal surgery practice.

Study design:

Retrospective review of 710 patients undergoing endoscopic laryngeal surgery over a one-year period.

Methods:

Medical records of the endoscopic laryngeal procedures were reviewed; 386/710 had been performed in the clinic and 324/710 in the operating theatre under general anaesthesia. Indications for the procedures were classified by pathology.

Results:

Pulsed potassium-titanyl-phosphate laser was used in 209/386 clinic procedures. The indications for these procedures were: dysplasia (114/209 procedures), papillomatosis (89/209), varices or ectasia (three of 209), and ‘other’ (three of 209). Pulsed potassium-titanyl-phosphate laser was used in 178/324 operating theatre endoscopic laryngeal procedures. The indications for these procedures were: cancer (54/178 procedures), dysplasia (52/178), papillomatosis (38/178), varices or ectasia (13/178), polyps (six of 178), nodules (six of 178), stenosis (five of 178), granulation (three of 178), and amyloid (one of 178).

Conclusions:

Due to its versatility, the 532 nm pulsed potassium-titanyl-phosphate laser is our most commonly utilised instrument for performing endoscopic laryngeal surgery.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Eastern Section of the Triological Society, 24 January 2009, Boston, Massachusetts, USA.

References

1 Anderson, RR, Parrish, JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 1983;220:524527CrossRefGoogle ScholarPubMed
2 Anderson, RR, Parrish, JA. Microvasculature can be selectively damaged using lasers: a basic theory and experimental evidence in human skin. Lasers Surg Med 1981;1:263–76CrossRefGoogle ScholarPubMed
3 Anderson, RR, Jaenicke, KF, Parrish, JA. Mechanisms of selective vascular changes caused by dye lasers. Lasers Surg Med 1983;3:211–15Google ScholarPubMed
4 Zeitels, SM, Akst, LM, Burns, JA, Hillman, RE, Broadhurst, MS, Anderson, RR. Office based 532 nm pulsed-KTP laser treatment of glottal papillomatosis and dysplasia. Ann Otol Rhinol Laryngol 2006;115:679–85CrossRefGoogle ScholarPubMed
5 Zeitels, SM, Akst, LM, Burns, JA, Hillman, RE, Broadhurst, MS, Anderson, RR. Pulsed angiolytic laser treatment of ectasias and varices in singers. Ann Otol Rhinol Laryngol 2006;115:571–80CrossRefGoogle ScholarPubMed
6 Bower, CM, Flock, S, Waner, M. Flash pump dye laser treatment of laryngeal papillomas. Ann Otol Rhinol Laryngol 1998;107:1001–5CrossRefGoogle ScholarPubMed
7 McMillan, K, Shapshay, SM, McGilligan, JA. A 585-nanometer pulsed dye laser treatment of laryngeal papillomas; preliminary report. Laryngoscope 1998;108:968–72CrossRefGoogle ScholarPubMed
8 Zeitels, SM. Papillomatosis. In: Atlas of Phonomicrosurgery and Other Endolaryngeal Procedures for Benign and Malignant Disease. San Diego: Singular, 2001;119–31Google Scholar
9 Valdez, TA, McMillan, K, Shapshay, SM. A new laser treatment for vocal cord papillomas – 585 nanometer pulsed dye laser. Otolaryngol Head Neck Surg 2001;124:421–5CrossRefGoogle Scholar
10 Franco, RA, Zeitels, SM, Farinelli, WA, Anderson, RR. 585-nm pulsed dye laser treatment of glottal papillomatosis. Ann Otol Rhinol Laryngol 2002;111:486–92CrossRefGoogle ScholarPubMed
11 Burns, JA, Zeitels, SM, Anderson, RR. 523 nm pulsed KTP laser treatment of papillomatosis under general anesthesia. Laryngoscope 2007;117:1500–4CrossRefGoogle Scholar
12 Zeitels, SM. Vocal fold atypia/dysplasia and carcinoma. In: Atlas of Phonomicrosurgery and Other Endolaryngeal Procedures for Benign and Malignant Disease. San Diego: Singular, 2001;177218Google Scholar
13 Franco, RA, Zeitels, SM, Farinelli, WA, Faquin, W, Anderson, RR. 585-nm pulsed dye laser treatment of glottal dysplasia. Ann Otol Rhinol Laryngol 2003;112:751–8CrossRefGoogle ScholarPubMed
14 Zeitels, SM, Franco, RA, Dailey, SH, Burns, JA, Hillman, RE, Anderson, RR. Office-based treatment of glottal dysplasia and papillomatosis with the 585-nm pulsed dye laser and local anesthesia. Ann Otol Rhinol Laryngol 2004;113:265–76CrossRefGoogle ScholarPubMed
15 Zeitels, SM, Hillman, RE, Desloge, R, Mauri, M, Doyle, PA. Phonomicrosurgery in singers and performing artists: treatment outcomes, management theories, and future directions. Ann Otol Rhinol Laryngol 2002;111:2140CrossRefGoogle Scholar
16 Zeitels, SM, Burns, JA, Lopez-Guerra, G, Anderson, RR, Hillman, RE. Photoangiolytic laser treatment of early glottic cancer: a new management strategy. Ann Otol Rhinol Laryngol 2008;117:124CrossRefGoogle Scholar
17 Zeitels, SM, Burns, JA. Office-based laryngeal surgery with local anesthesia. Curr Opin Otolaryngol Head Neck Surg 2007;15:141–7CrossRefGoogle ScholarPubMed
18 Zeitels, SM, Burns, JA. Office-based laryngeal surgery with the 532 nm pulsed-potassium-titanyl-phosphate laser. Curr Opin Otolaryngol Head Neck Surg 2007;15:394400CrossRefGoogle ScholarPubMed
19 Jako, GJ, Kleinsasser, O. Endolaryngeal micro-diagnosis and microsurgery.Google Scholar
20 Folkman, J. Tumor angiogenesis: therapeutic implications. N Engl J Med 1971;285:1182–6Google ScholarPubMed
21 Folkman, J, Angiogenesis. In: Braunwauld, ASFE, Kasper, DL, Hauser, SL, Longo, DL, Jameson, JL, eds. Harrison's Textbook of Internal Medicine. New York: McGraw Hill, 2001;517–30Google Scholar
22 Broadhurst, MS, Kobler, JB, Akst, LM, Burns, JA, Heaton, JT, Anderson, RR et al. Effects of 532 nm pulsed-KTP laser parameters on vessel ablation in the avian chorioallantoic membrane: implications for vocal-fold mucosal photoangiolysis. Laryngoscope 2007;117:220–5CrossRefGoogle Scholar