Analysis of Potassium Titanyl Phosphate Laser Settings and Voice Outcomes in the Treatment of Reinke's Edema

作者：Young VyVy N^*; Mallur Pavan S; Wong Adrienne W; Mandal Rajarsi; Staltari Giuseppe V; Gartner Schmidt Jackie; Rosen Clark A

来源：Annals of Otology, Rhinology and Laryngology, 2015, 124(3): 216-220.

DOI：10.1177/0003489414549155

• KTP
• laser
• outcome
• Reinke's edema
• surgery
• voice

Objective: Despite increased clinical utility of the 532-nnn potassium titanyl phosphate (KTP) laser, no studies have examined outcomes for Reinke's edema (RE) as a function of laser parameters and initial treatment effects. Variability in delivery parameters, fiber-to-tissue distance, and immediate end-tissue effects limits universal application of existing study outcomes. We examine voice outcomes using standardized treatment classification, providing justification for laser parameter selection and immediate tissue effect in clinical use.
Methods: Retrospective review of 9 patients who underwent KTP laser treatment for RE. Demographics, RE severity, laser settings, total laser energy, and immediate tissue effects were correlated with quantified voiee outcomes.
Results: An average of 157 joules (6-640 J) was delivered over a 0.369-second exposure time (0.1-0.9 seconds). Immediate tissue effects varied from nonablative treatment (type 1 and type 11) to ablation without tissue removal (type 111). Overall, Voice Handicap Index-10 (VHI-10) decreased by 8.23; improvement was most pronounced with type 11 treatments (delta VHI-10 = 12). No complications were encountered.
Conclusion: Potassium titanyl phosphate laser can be safely and effectively used to improve voice in RE patients regardless of severity. This is the first study to provide detailed information on laser settings, energy delivery, and treatment effect in RE management; these results may guide clinical use of this modality, especially for novice laser surgeons.

• 出版日期2015-3