Proposed classification system for reporting 532-nm pulsed potassium titanyl phosphate laser treatment effects on vocal fold lesions
Proposed classification system for reporting 532-nm pulsed potassium titanyl phosphate laser treatment effects on vocal fold lesions
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DOI：
10.1002/lary.22451
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发表时间：
2014-05-01
期刊：
影响因子：
2.6
通讯作者：
Rosen, Clark A.
中科院分区：
文献类型：
--
作者：
Mallur, Pavan S.;Johns, Michael M.;Rosen, Clark A.
目的/假设目前，没有报告磷酸钛酸钾（KTP）激光治疗结果的标准。本研究的目的是建立一种有效的分类模式来报告激光治疗后的即时组织效应。研究设计：学术喉科医师使用评分系统评估KTP激光视频序列。方法建立五级分类体系；包括非接触性血管溶解、上皮变白、上皮破坏、接触性上皮消融和接触性上皮消融伴组织切除。对每个治疗效果进行前瞻性录像。10个治疗记录，2个重复记录，提交给7个学术喉科医生，他们被要求根据给定的分类方案对每个录音进行分类。结果联合评价者对治疗的总体评价准确率为82%。7位评论者中有6位表现出完美的内部可靠性。评级夹的准确性与先前进行的532 nm KTP或585 nm脉冲染料激光手术的次数无关，但在实践中显示出与总年数相关的趋势。本研究表明，KTP激光效应的标准化报告是可行的。结论：我们认为，KTP治疗的结果应该使用一个经过验证的立即激光效果分类系统，以及特定的激光设置来报告。该分类系统允许将来系统地评估单次激光治疗的长期治疗结果。证据水平喉镜，24 (4):1170-1175,2014
Objectives/HypothesisCurrently, no standard exists for reporting treatment results for the potassium titanyl phosphate (KTP) laser. The goal of this study was to establish a validated classification schema for reporting immediate tissue effects after laser treatment.Study DesignEvaluation of KTP laser video sequences by academic laryngologists with use of the rating system.MethodsA five-point classification system was developed; this included noncontact angiolysis, epithelial blanching, epithelial disruption, contact epithelial ablation, and contact epithelial ablation with tissue removal. Video recordings were made prospectively for each treatment effect. Ten treatment recordings, with two repeated recordings, were presented to seven academic laryngologists, who were asked to categorize each based on the given classification scheme.ResultsOverall accuracy for the combined reviewers in rating the treatments was 82%. Six of seven reviewers showed perfect intrarater reliability. Accuracy in rating clips did not correlate with the previous number of 532-nm KTP or 585-nm pulsed dye laser procedures performed but showed a trend toward correlating with total years in practice. This study reveals that standardized reporting of effects of the KTP laser is feasible.ConclusionsWe believe that results of KTP treatment should be reported using a validated classification system of immediate laser effect, along with specific laser settings. This classification system allows for future systematic evaluation of long-term treatment results prospectively from single laser treatments.Level of Evidence4. Laryngoscope, 124:1170-1175, 2014