Park Young Min, Lim Jae-Yol, Kang Min Seok, Choi Hong-Shik
1 Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.
2 Institute of Logopedics and Phoniatrics, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.
Ann Otol Rhinol Laryngol. 2019 May;128(5):377-383. doi: 10.1177/0003489419826132. Epub 2019 Jan 29.
We have been performing glottoplasty using angiolytic laser, including pulsed dye laser (PDL) or potassium titanyl phosphate (KTP) laser, for the treatment of sulcus vocalis. In this study, we retrospectively reviewed the treatment results of sulcus vocalis patients who had undergone glottoplasty using angiolytic laser and evaluated the efficacy and safety of this surgical technique.
From January 2008 to April 2016, 79 patients with sulcus vocalis who underwent angiolytic LASER-assisted glottoplasty were enrolled in the study.
Of the 79 patients who participated in this study, 55 were male, and 24 were female. PDL was used for glottoplasty in 68 patients, and KTP was used in the remaining 11 patients. Seventy-seven patients underwent surgery for bilateral vocal cord lesions, and only 2 patients underwent surgery for unilateral vocal cord lesion. After glottoplasty using angiolytic laser, most patients showed continuous improvement of the GRBAS (grade, roughness, breathiness, asthenia, strain) score and Voice Handicap Index score until 6 months after the operation. In addition, we observed improvement of objective voice indices such as noise to harmonic ratio, jitter, shimmer, and maximal phonation time postoperatively.
Based on these results, we confirmed the efficacy and safety of glottoplasty using angiolytic laser in sulcus vocalis patients. Further studies are needed to confirm appropriate laser settings such as frequency of treatments and total energy delivered to the lesion. Also, multi-institutional studies are needed to confirm the efficacy and safety of the operation.
我们一直在使用血管消融激光,包括脉冲染料激光(PDL)或磷酸钛钾(KTP)激光进行声门成形术,用于治疗声带沟。在本研究中,我们回顾性分析了接受血管消融激光声门成形术的声带沟患者的治疗结果,并评估了该手术技术的有效性和安全性。
2008年1月至2016年4月,79例接受血管消融激光辅助声门成形术的声带沟患者纳入本研究。
参与本研究的79例患者中,男性55例,女性24例。68例患者使用PDL进行声门成形术,其余11例患者使用KTP。77例患者接受双侧声带病变手术,仅2例患者接受单侧声带病变手术。使用血管消融激光进行声门成形术后,大多数患者在术后6个月内GRBAS(分级、粗糙度、气息声、无力、紧张)评分和嗓音障碍指数评分持续改善。此外,我们观察到术后客观嗓音指标如噪声谐波比、抖动、闪烁和最大发声时间有所改善。
基于这些结果,我们证实了血管消融激光声门成形术在声带沟患者中的有效性和安全性。需要进一步研究以确定合适的激光参数,如治疗频率和输送到病变部位的总能量。此外,还需要多机构研究来证实该手术的有效性和安全性。