Laryngeal Laser Surgery for Recurrent Respiratory Papillomatosis, Cancer and Dysplasia: Operating Room and Office

2009 ◽  
Vol 19 (2) ◽  
pp. 74-83
Author(s):  
Steven M. Zeitels ◽  
Robert E. Hillman
Keyword(s):  
Laser Treatment ◽  
Operating Room ◽  
Laser Surgery ◽  
Vocal Fold ◽  
Recurrent Respiratory Papillomatosis ◽  
Ktp Laser ◽  
Thulium Laser ◽  
Skill Sets ◽  
The Cost ◽  
Angiolytic Laser

Abstract Since their introduction in laryngology over 30 years ago, lasers have facilitated critically-important innovations that have now evolved into office-based surgery. Recent advances include the application of angiolytic lasers that treat vocal fold lesions by ablating vasculature and the use of the thulium laser as a more efficient and versatile tissue dissector. In our experience, the 532nm pulsed KTP laser has emerged thus far as the optimal angiolytic laser to treat vocal-fold lesions both in the operating room and in the clinic setting. Despite the fact that the skill-sets to adopt office-based laser treatment are an easy transition for most laryngological surgeons, the primary impediment to widespread adoption is the cost of the technology. Furthermore, critical development of these new lasers will occur with broader use of these lasers in other surgical disciplines, which should diminish costs for all surgeons and thereby promote better outcomes for individuals with voice disorders.

Laser Surgery of the Larynx: The Case for Caution

1992 ◽  
Vol 71 (11) ◽  
pp. 593-595 ◽  
Author(s):  
Robert Thayer Sataloff ◽  
Joseph R. Spiegel ◽  
Mary Hawkshaw ◽  
Alyson Jones
Keyword(s):  
Special Education ◽  
Operating Room ◽  
Co2 Laser ◽  
Laser Surgery ◽  
Vocal Fold ◽  
Thermal Injury ◽  
Surgical Skill ◽  
Laryngeal Surgery ◽  
Laryngeal Lesions ◽  
Operating Room Team

Laser surgery has been advocated for treatment of many laryngeal lesions. Although the CO2 laser has many advantages, its safe use requires special education of the surgeon and operating room team, and considerable surgical skill. Several dangers inherent in laser use for laryngeal surgery must be considered. These include vocal fold scarring secondary to thermal injury, loss of histopathologically important tissue through vaporization, airway fire and others. Laser-related complications must be considered whenever use of this instrument is contemplated.

Complications of Laser Surgery for Recurrent Respiratory Papillomatosis

1987 ◽  
Vol 96 (6) ◽  
pp. 639-644 ◽  
Author(s):  
Dennis M. Crockett ◽  
Brian F. McCabe ◽  
Cynthia J. Shive
Keyword(s):  
Laser Surgery ◽  
Vocal Fold ◽  
Pediatric Patients ◽  
Tissue Injury ◽  
Severe Disease ◽  
Operative Procedure ◽  
Recurrent Respiratory Papillomatosis ◽  
Anesthetic Technique ◽  
Direct Visualization ◽  
Delayed Complications

During an 8-year period, 66 patients with recurrent respiratory papillomatosis underwent 890 laser microlaryngoscopy procedures. A retrospective analysis of immediate and delayed complications occurring with laser microlaryngoscopy in the treatment of these patients revealed that complications secondary to anesthetic technique and laser methodology were remarkably low (0.3%). Delayed complications of tissue injury (36% of pediatric patients and 17% of adult patients) were more frequent and included anterior glottic webbing, interarytenoid scarring and arytenoid fixation, vocal fold fibrosis, and generalized endolaryngeal glottic stenosis. All patients were evaluated by direct visualization and recording at the time of the operative procedure, as well as by review of intraoperative photographs. A smaller group of patients underwent analysis of voice recordings and laryngeal stroboscopy. The frequency and severity of tissue injury was higher in the patients with more severe disease who underwent multiple operative procedures.

scholarly journals Angiolytic Laser Surgery for Vocal Fold Polyps

2014 ◽  
Vol 26 (1) ◽  
pp. 18-21
Author(s):  
Toshiki Kobayashi ◽  
Shigeru Hirano ◽  
Ichiro Tateya ◽  
Masanobu Mizuta ◽  
Juichi Ito
Keyword(s):  
Laser Surgery ◽  
Vocal Fold ◽  
Angiolytic Laser

scholarly journals Comparative efficacy and safety of transurethral laser surgery with holmium laser, KTP laser, 2-micron laser or thulium laser for the treatment of non-muscle invasive bladder carcinoma: a protocol of network meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055840
Author(s):  
Jinfeng Yu ◽  
Junbiao Zheng
Keyword(s):  
Laser Surgery ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Holmium Laser ◽  
Cochrane Library ◽  
Ktp Laser ◽  
Efficacy And Safety ◽  
Thulium Laser ◽  
Comparative Efficacy ◽  
Muscle Invasive

IntroductionThe potential of transurethral laser surgery in treating non-muscle invasive bladder cancer (NMIBC) has been confirmed, however which types of lasers may be preferentially prescribed remains a debate. The aim of this network meta-analysis is to investigate the comparative efficacy and safety of transurethral laser surgery with four common types of laser including holmium laser, potassium titanylphosphate (KTP) laser, 2-micron laser or thulium laser for the treatment of NMIBC.Methods and analysisA systematic search will be conducted to search all potentially eligible randomised controlled trials comparing different transurethral laser surgeries with each other or with standard transurethral resection among patients with NMIBC in PubMed, Embase, the Cochrane library, China National Knowledge Infrastructure, Wanfang database and Chongqing VIP from their inception until 31 May 2021. Two reviewers will be asked to independently select eligible studies, and assess the risk of bias of individual study with Cochrane risk of bias assessment tool. A random-effects network meta-analysis based on Markov chain Monte Carlo method will be carried out. Ranking probabilities will be considered to rank all laser types. Quantitative analysis will be carried out by using WinBUGS V.1.4.3.Ethics and disseminationEthical approval is not required because this is a network meta-analysis of published data. We will submit all findings to some conferences for preliminary communication and to a peer-reviewed journal for publication.Trial registration number10.17605/OSF.IO/TD9MW.

Laryngoscopic KTP Laser Surgery for Adult Hypopharyngolaryngeal Venous Malformation

2013 ◽  
Vol 64 (3) ◽  
pp. 212-218
Author(s):  
Kenichi Watanabe ◽  
Yuuri Okumura ◽  
Koji Hozawa
Keyword(s):  
Laser Surgery ◽  
Venous Malformation ◽  
Ktp Laser

The estimated healthcare cost of diabetic retinopathy in Indonesia and its projection for 2025

2019 ◽  
Vol 104 (4) ◽  
pp. 487-492 ◽  
Author(s):  
Muhammad Bayu Sasongko ◽  
Firman Setya Wardhana ◽  
Gandhi Anandika Febryanto ◽  
Angela Nurini Agni ◽  
Supanji Supanji ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Laser Treatment ◽  
Healthcare Cost ◽  
Cost Of Illness ◽  
Public Health Intervention ◽  
Transportation Cost ◽  
Population Based ◽  
State Budget ◽  
Illness Model ◽  
The Cost

PurposeTo estimate the total healthcare cost associated with diabetic retinopathy (DR) in type 2 diabetes in Indonesia and its projection for 2025.MethodsA prevalence-based cost-of-illness model was constructed from previous population-based DR study. Projection for 2025 was derived from estimated diabetes population in 2025. Direct treatment costs of DR were estimated from the perspective of healthcare. Patient perspective costs were obtained from thorough interview including only transportation cost and lost of working days related to treatment. We developed four cost-of-illness models according to DR severity level, DR without necessary treatment, needing laser treatment, laser +intravitreal (IVT) injection and laser + IVT +vitrectomy. All costs were estimated in 2017 US$.ResultsThe healthcare costs of DR in Indonesia were estimated to be $2.4 billion in 2017 and $8.9 billion in 2025. The total cost in 2017 consisted of the cost for no DR and mild–moderate non-proliferative DR (NPDR) requiring eye screening ($25.9 million), severe NPDR or proliferative DR (PDR) requiring laser treatment ($0.25 billion), severe NPDR or PDR requiring both laser and IVT injection ($1.75 billion) and advance level of PDR requiring vitrectomy ($0.44 billion).ConclusionsThe estimated healthcare cost of DR in Indonesia in 2017 was considerably high, nearly 2% of the 2017 national state budget, and projected to increase significantly to more than threefold in 2025. The highest cost may incur for DR requiring both laser and IVT injection. Therefore, public health intervention to delay or prevent severe DR may substantially reduce the healthcare cost of DR in Indonesia.

Long-Term Histologic Effects of Inferior Turbinate Laser Surgery

2001 ◽  
Vol 124 (4) ◽  
pp. 459-463 ◽  
Author(s):  
David B. Wexler ◽  
Gilead Berger ◽  
Ari Derowe ◽  
Dov Ophir
Keyword(s):  
Laser Treatment ◽  
Laser Surgery ◽  
Laser Energy ◽  
Inferior Turbinate ◽  
Surface Epithelium ◽  
Marked Diminution ◽  
Connective Tissue Matrix ◽  
Tissue Matrix ◽  
Histologic Changes

OBJECTIVE: In this study we sought to define the histologic changes produced by laser treatment of inferior turbinates. STUDY DESIGN: Eight inferior turbinates with prior laser treatment (mean, 26.8 months) were analyzed by light microscopy after turbinectomy for relief of refractory nasal obstruction. Histologic findings were compared with those of a group of 8 hypertrophic inferior turbinates that had no previous laser surgery. RESULTS: Laser-treated areas of the inferior turbinates demonstrated a histologically bland appearance, with marked diminution of seromucinous glands and relative preponderance of connective tissue matrix. Prominence of venous sinusoids was also significantly reduced in the laser-treated areas. Surface epithelium including goblet cells was reconstituted over the areas of laser application. CONCLUSION: Clinical laser surgery of the inferior turbinate produces striking long-term histologic changes. SIGNIFICANCE: The data suggest a differential response of turbinate histologic components to application of laser energy, with the glandular component being particularly sensitive. Further correlative study is needed to clarify the clinical significance of laser-induced histologic changes in inferior turbinates.

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