Photoangiolytische Laser in der Laryngologie

Heß, Markus; Fleischer, Susanne

doi:10.1055/a-1071-0410

Cited by 10 publications

(11 citation statements)

References 14 publications

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“…60 (3) The fiber‐based delivery of the KTP laser with the technical advancement of distal‐tip endoscopy enables surgical procedures to be performed in office settings under local anesthesia, meaning that considerable time and medical expenses can be saved. 30 , 37 Nevertheless, it should be noted that CO 2 laser treatment has also been reported in a recent study to have been performed in an office setting. 43 Thus, further studies should be conducted that specifically compare differences when the two lasers are used in an office setting to treat RRP.…”

Section: Discussionmentioning

confidence: 90%

“…The tumor boundary can be clearly seen under the microscope, and the level of incision can be distinguished so that the lesion can be completely removed while minimizing collateral damage 60 . (3) The fiber‐based delivery of the KTP laser with the technical advancement of distal‐tip endoscopy enables surgical procedures to be performed in office settings under local anesthesia, meaning that considerable time and medical expenses can be saved 30,37 . Nevertheless, it should be noted that CO 2 laser treatment has also been reported in a recent study to have been performed in an office setting 43 .…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have reported successful treatment of multiple vocal diseases, such as papilloma, varix, polyps, Reinke edema, vocal process granuloma, ectasia, and glottal dysplasia 28 . The angiolytic properties of KTP shrink lesions through photothermolysis and the laser energy can be absorbed by hemoglobin 10,29,30 . Given these advantages, the KTP laser could be the future of RRP treatment.…”

Section: Introductionmentioning

confidence: 99%

“… 28 The angiolytic properties of KTP shrink lesions through photothermolysis and the laser energy can be absorbed by hemoglobin. 10 , 29 , 30 Given these advantages, the KTP laser could be the future of RRP treatment. However, the CO 2 laser remains the first choice for treating RRP by most hospitals in China due to the lack of comparative studies or consensus on which laser is better for RRP therapy.…”

Section: Introductionmentioning

confidence: 99%

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Comparing KTP and CO₂ laser excision for recurrent respiratory papillomatosis: A systematic review

Yang

Xie

Seyler

2022

Laryngoscope Investig Oto

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Objective The CO2 laser and 532 nm potassium titanyl phosphate (KTP) laser have been applied to treat recurrent respiratory papillomatosis (RRP). This systematic review sought to compare outcome differences between these two methods. Data Sources Embase, Web of Science, PubMed, and the Cochrane Library. Review Methods CO2 laser and KTP laser studies were obtained by keyword searches of four authoritative medical databases. Articles were screened and retained when conforming to inclusion criteria. The primary outcome was cure rate; the secondary outcomes were recurrence, death, remission, clearance, and human papillomavirus (HPV)‐detected rates, as well as laser effectiveness rates. Postoperative complications rate was the safety outcome measure. All outcomes were summarized within the CO2 and KTP groups, with results statistically compared (p < .05). Results Overall, the cure rates were 87.25% (KTP group) and 75.98% (CO2 group; p < .05). Complication rates significantly differed between the KTP (2.32%) and CO2 (17.71%) groups (p < .0001). There was a relatively higher but not significant difference in the recurrence rates between the CO2 (18.6%) and KTP (10.87%) groups (p = .1595). The CO2 group remission rate was considerably lower (38.9%) than the KTP group (88.46%, p < .0001). HPV‐detected and clearance rates were only reported for the CO2 group. The bias risks were 13.1 ± 1.45 (CO2) and 13.6 ± 1.52 (KTP) for the two groups, indicating evidence was of fair quality. Conclusion Overall, KTP laser excision showed significantly better postoperative clinical outcomes than the CO2 laser, with a lower failure rate. Available fair‐quality evidence suggests KTP laser excision might be better for treating RRP. Nevertheless, more high‐quality randomized controlled studies are needed to compare these two surgical techniques, particularly in terms of reporting functional data such as vocal outcomes.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparing KTP and CO₂ laser excision for recurrent respiratory papillomatosis: A systematic review

Yang

Xie

Seyler

2022

Laryngoscope Investig Oto

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“…3 ). Selektives photoangiolytisches Laserlicht wie Kalium-Titanyl-Phosphat (KTP; 532 nm) oder der „blaue Laser“ (445 nm) erweitern damit die bisherigen therapeutischen Optionen bei Eingriffen im Behandlungsstuhl [ 11 ]. Bei allen Vorteilen, welche die photoangiolytische Lasertechnik im „office-based“ Setting mit sich bringt, müssen potenzielle Risiken schwankender Laserenergieabgaben bei mobilen Stimmlippen und gleichzeitig veränderbarer Position der Laserspitze weiterhin geklärt werden.…”

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Ambulante Phonochirurgie

Bohlender

2021

HNO

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ZusammenfassungWesentliche und neue Impulse, die das Behandlungskonzept für ambulante phonochirurgische Eingriffe am unsedierten Patienten betreffen, stammen aktuell aus dem angloamerikanischen Sprachraum. Die dort etablierten „office-based procedures“ werden als eine Alternative zu vielen konventionellen operativen Larynxeingriffen in Vollnarkose propagiert. Maßgeblich für diese Entwicklung ist der Einsatz neuer endoskopischer Techniken in Kombination mit photoangiolytischen Laserverfahren (KTP-Laser und blauer Laser), die eine sichere und effiziente ambulante Phonochirurgie ermöglichen. Die Akzeptanz seitens der Patienten ist hoch, da ambulante Eingriffe als risikoärmer gelten. Ungeachtet der verbreiteten Euphorie fehlen weiterführende Studien, welche die medizinischen Entscheidungskriterien und das Sicherheitsmanagement bei dieser neuen ambulanten Ausrichtung der Kehlkopfchirurgie bewerten.

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Office‐Based Treatment of Vocal Fold Polyps and Reinke's Edema: A Rational Comparison With Suspension Laryngoscopy

et al. 2023

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ObjectiveBenign laryngeal lesions have traditionally been treated through suspension laryngoscopy under general anesthesia (GA). Recently, the development of operative videoendoscopes coupled with photoangiolytic lasers has allowed clinicians to treat these conditions in the outpatient clinic. We report our experience in the office‐based (OB) setting for the treatment of patients affected by vocal fold polyps (VFPs) and Reinke's edema (RE), comparing it to patients treated under GA.MethodsA retrospective analysis was conducted on patients affected by VFP or RE. A 445 nm diode blue laser was used through the operative channel of a flexible video‐endoscope for OB procedures, while GA surgeries were carried out with cold steel instrumentation. The Voice Handicap Index‐10 (VHI‐10) represented the primary outcome. Endoscopic outcomes, duration, and morbidity of the procedures were investigated as secondary outcomes.ResultsA total of 153 patients were retrospectively enrolled. 52 were treated in an OB setting, while 91 underwent GA. Regarding patients with RE, both the OB and GA cohorts showed a significant improvement in VHI‐10 (from 12.7 to 2.6 and 19.5 to 5.1, respectively; p < 0.001), as did those with VFPs (from 11.8 to 2.3 and 15.9 to 2.9 respectively; p < 0.001). No differences were found when comparing VHI‐10 in the OB and GA cohorts. The mean procedural time of OB treatment (4.9 min) was significantly shorter than GA (37.1 min). No adverse events were reported.ConclusionOur data demonstrate the efficacy and safety of the OB setting. For selected patients, OB treatments offer comparable vocal outcomes, favorable morbidity, and reduced operation times, making them an appealing alternative to the traditional approach.Level of Evidence3 Laryngoscope, 133:2665–2672, 2023

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Photoangiolytische Laser in der Laryngologie

Cited by 10 publications

References 14 publications

Comparing KTP and CO₂ laser excision for recurrent respiratory papillomatosis: A systematic review

Comparing KTP and CO₂ laser excision for recurrent respiratory papillomatosis: A systematic review

Ambulante Phonochirurgie

Office‐Based Treatment of Vocal Fold Polyps and Reinke's Edema: A Rational Comparison With Suspension Laryngoscopy

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Photoangiolytische Laser in der Laryngologie

Cited by 10 publications

References 14 publications

Comparing KTP and CO2 laser excision for recurrent respiratory papillomatosis: A systematic review

Comparing KTP and CO2 laser excision for recurrent respiratory papillomatosis: A systematic review

Ambulante Phonochirurgie

Office‐Based Treatment of Vocal Fold Polyps and Reinke's Edema: A Rational Comparison With Suspension Laryngoscopy

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Comparing KTP and CO₂ laser excision for recurrent respiratory papillomatosis: A systematic review

Comparing KTP and CO₂ laser excision for recurrent respiratory papillomatosis: A systematic review