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多机构应用经口 KTP 激光治疗喉部病变的经验。

Multi-institutional experience with the in-office potassium titanyl phosphate laser for laryngeal lesions.

机构信息

Department of Otolaryngology, New York University School of Medicine, New York City, New York 10016, USA.

出版信息

J Voice. 2012 Nov;26(6):806-10. doi: 10.1016/j.jvoice.2012.04.003. Epub 2012 Jul 13.

Abstract

OBJECTIVE/HYPOTHESIS: To determine the efficacy of the potassium titanyl phosphate (KTP) laser in lesion reduction, as well as preservation of mucosal wave and glottic closure in a cohort of patients with benign laryngeal pathology across multiple institutions.

STUDY DESIGN

Multi-institutional and retrospective.

METHODS

One hundred two patients who underwent in-office KTP procedures at multiple academic laryngology practices with at least a single follow-up visit were included. Image analysis was used to quantify vocal fold lesion size before and after treatment. A subset of images was analyzed by expert reviewers to determine the impact of this treatment on glottic closure and mucosal wave.

RESULTS

Statistically, when considering all lesions, KTP induced a significant reduction in lesion size. Post hoc analyses revealed some lesion specificity; all lesions decreased in size, with the exception of vocal fold scar. Mucosal wave and glottic closure were improved or unchanged in more than 90% of the patients examined. The inter- and intrarater reliabilities of the lesion quantification method were excellent.

CONCLUSIONS

With great care and insight, the KTP laser appears to be a valuable tool for the treatment of various benign laryngeal lesions. Furthermore, KTP laser therapy appears to preserve or improve mucosal wave and glottic closure. The lesion measurement protocol previously described by our group appears to be reliable.

摘要

目的/假设:在多个机构的患者中,确定钾钛磷酸(KTP)激光在减少病变,以及保护黏膜波和声带闭合方面的疗效,这些患者患有多种良性喉部病变。

研究设计

多机构和回顾性研究。

方法

在多个学术性喉科实践中,有 102 名患者接受了 KTP 门诊手术,并且至少有一次随访。使用图像分析来量化治疗前后声带病变的大小。通过专家审查者分析了一部分图像,以确定这种治疗对声门闭合和黏膜波的影响。

结果

从统计学上考虑所有病变时,KTP 可显著减小病变大小。事后分析显示出一些病变的特异性;除声带瘢痕外,所有病变均减小。在接受检查的患者中,黏膜波和声带闭合改善或不变的比例超过 90%。病变定量方法的组内和组间可靠性均极佳。

结论

在非常谨慎和有洞察力的情况下,KTP 激光似乎是治疗各种良性喉部病变的有价值的工具。此外,KTP 激光治疗似乎可以保留或改善黏膜波和声带闭合。我们小组之前描述的病变测量方案似乎是可靠的。

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