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门诊行KTP激光消融治疗声带肉芽肿的疗效

Treatment Outcomes of In-Office KTP Ablation of Vocal Fold Granulomas.

作者信息

Dominguez Laura M, Brown Raymond J, Simpson C Blake

机构信息

1 Department of Otolaryngology, UT Health Science Center San Antonio, San Antonio, Texas, USA.

出版信息

Ann Otol Rhinol Laryngol. 2017 Dec;126(12):829-834. doi: 10.1177/0003489417738790. Epub 2017 Oct 27.

Abstract

OBJECTIVE

To determine the effectiveness of in-office potassium-titanyl-phosphate (KTP) treatment of vocal fold granulomas and identify any predictors of complete lesion resolution.

METHODS

A retrospective review of patients who underwent in-office KTP ablation of vocal fold granulomas between 2007 and 2016 was performed. Medical records were reviewed for use of acid suppression medication, prior surgical treatment, voice therapy, laser settings, number of treatments, follow-up time, and Voice Handicap Index-10 (VHI-10) scores.

RESULTS

Twenty-six patients underwent a total of 43 laser treatments. Eighty percent of patients were previously on acid suppression medication, and 42.3% had failed previous endoscopic treatments. Patients underwent a mean number of 1.65 ± 1.16 in-office treatments with decrease in size in 96.2% of cases. The VHI-10 was not significantly affected. Complete resolution occurred in 73.1% of cases with follow-up time ranging from 1 to 86 months (median = 9.5 months). No recurrences occurred in patients with complete resolution. Other than undergoing a single KTP treatment, no variable was found to be predictive of complete lesion resolution. Granuloma etiology was not predictive of lesion resolution but did correlate with symptom improvement.

CONCLUSION

In-office pulsed KTP laser is an effective treatment option for vocal fold granulomas as the lesion resolves in the majority of cases.

摘要

目的

确定诊室磷酸钛氧钾(KTP)治疗声带肉芽肿的有效性,并确定病变完全消退的预测因素。

方法

对2007年至2016年间在诊室接受KTP消融声带肉芽肿的患者进行回顾性研究。查阅病历,了解抑酸药物的使用、既往手术治疗、嗓音治疗、激光设置、治疗次数、随访时间和嗓音障碍指数-10(VHI-10)评分。

结果

26例患者共接受43次激光治疗。80%的患者既往使用过抑酸药物,42.3%的患者既往内镜治疗失败。患者平均接受1.65±1.16次诊室治疗,96.2%的病例病变大小减小。VHI-10未受到显著影响。73.1%的病例实现完全消退,随访时间为1至86个月(中位数=9.5个月)。完全消退的患者未出现复发。除接受单次KTP治疗外,未发现其他变量可预测病变完全消退。肉芽肿病因不能预测病变消退,但与症状改善相关。

结论

诊室脉冲KTP激光是治疗声带肉芽肿的有效选择,因为大多数病例病变可消退。

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