Photocoagulation of Microvascular and Hemorrhagic Lesions of the Vocal Fold with the KTP Laser

Abstract

KTP laser photocoagulation is a relatively simple and safe procedure for treating microvascular lesions of the vocal fold. It is not recommended for photocoagulation of hemorrhagic polyps or hematomas, because such lesions have little blood flow inside and thus photocoagulation is usually impossible or requires too much laser energy. However, photocoagulation of perimeter or feeding vessels of such disorders may facilitate the following procedure by avoiding unnecessary bleeding, as well as preventing recurrence of hemorrhagic lesions.

Comprehensive Outcome Researches of Intralesional Steroid Injection on Benign Vocal Fold Lesions

“…15 The presence of ectasias (defined as spheroidal, tangible, subepithelial hemangioma) and varices (defined as enlarged, aberrant, and tortuous vessels) were recorded as well. 16,17 Patients with keratin cysts were excluded. Patients who had received previous phonomicrosurgery were also excluded from the study.…”

Acute vocal fold hemorrhage caught on video during office exam

“…The predisposing lesion is either a varix or ectasia, which results from microvascular trauma within the superficial layer of the lamina propria. [1][2][3] Patients often describe an acute dysphonic change in their voice after a vocal fold hemorrhage has occurred. Most patients will allow weeks or months to go by before seeking treatment for persistent or recurrent hoarseness.…”

“…4 CO 2 , pulsed potassium-titanyl-phosphate (KTP, 532 nm), and pulsed dye lasers (PDL, 585 nm) have been described in the treatment of vocal fold vascular lesions. 2,4,5 Pulsed KTP has been shown to cause less vessel wall rupture and improved hemostasis due to its longer pulse width when compared with the PDL. 6 Patients often present after the hemorrhage has resolved and only residual stiffness or scar can be seen.…”

Gefäßveränderungen der Stimmlippen – Teil 1: Horizontale Gefäßveränderungen

“…Fortgeschrittene Gefäßveränderungen, wie Varizen, Hämorrhagien und Polypen der Stimmlippen, behindern die Abrollbewegung der Schleimhaut jedoch relativ stark, zum einen wegen der Masseeff ekte, aber auch wegen der zerstörten vaskulärer Struktur der obersten Schicht der Lamina propria. Dadurch nimmt die Heiserkeit zu [ 20 ] , wobei meist ein rauer Stimmeindruck, der durch die Irregularitäten im Schwingungsablauf zu erklären ist, überwiegt. Besonders für professionelle Stimmnutzer im stimmlichen Hochleistungsbereich können kleinste vaskuläre Veränderun-gen der Stimmlippen wegen der konstant oder ständig wiederkehrenden submukösen Gefäßverdickungen, Einblutungen und Narben sowie den daraus resultierenden Masse-und Viskositätsveränderungen durchaus gravierende Folgen für die stimmliche Leistungsfähigkeit und den Stimmklang und somit auf die berufl iche Karriere haben.…”