532 nm pulsed potassium-titanyl-phosphate laser treatment of laryngeal papillomatosis under general anesthesia
532 nm pulsed potassium-titanyl-phosphate laser treatment of laryngeal papillomatosis under general anesthesia
复制标题
DOI：
10.1097/mlg.0b013e318064e869
复制
发表时间：
2007-08-01
期刊：
影响因子：
2.6
通讯作者：
Anderson, Rox
中科院分区：
文献类型：
--
作者：
Burns, James A.;Zeitels, Steven M.;Anderson, Rox
目的：血管溶解激光已被证明是喉乳头状瘤病的有效治疗策略。这些激光精确地针对乳头状病变微循环中的血红蛋白。我们之前已经在办公室环境（局部麻醉）中展示了基于光纤的532nm脉冲磷酸钛钾（KTP）激光器的优势。本研究首次报道了全身麻醉下脉冲ktp激光在喉镜检查中的应用。研究设计：一项前瞻性的前期研究在55名成年喉乳头状瘤患者中进行，以确定疾病反应。方法：在悬浮喉镜下，使用532路固体脉冲ktp激光器（脉冲宽度15 ms，最大输出5.25-7.5 J/脉冲，2 Hz重复频率，0.4 mm光纤，约20-80 J/cm(2)通量）治疗喉乳头状瘤病。所有患者术后均接受视喉镜检查，根据先前使用的评分量表评估疾病消退。结果：37例患者在18个月的研究期间接受了55次手术。对23例患者（35例手术）进行了近期随访和早期术后评估。14例患者（20例手术）地理位置遥远，仅在出现明显疾病复发症状后才返回。在35例可进行近期随访的手术中，35例中有28例（80%）实现了90%或更高的疾病消退，35例中有4例（11%）实现了75%至89%的疾病消退，35例中有3例（9%）实现了50%至74%的疾病消退。55例患者中有51例（93%）存在前联合病变，未发生新的织带/粘连。所有患者均报告其声带功能在治疗后有所改善。结论：532微米脉冲ktp激光治疗复发性呼吸道乳头状瘤病是有效的，这与我们作为办公室手术的经验相似。
Objectives: Angiolytic lasers have been shown to be an effective treatment strategy for laryngeal papillomatosis. These lasers precisely target hemoglobin within the microcirculation of papillary lesions. We have previously demonstrated the advantages of the fiber-based pulsed 532-nm potassium-titanyl-phosphate (KTP) laser in an office setting (with local anesthesia). This investigation provides the first report of the pulsed-KTP laser during microlaryngoscopy under general anesthesia.Study Design: A prospective pilot study was performed in 55 adult patients with laryngeal papillomatosis to determine disease response.Methods: During suspension microlaryngoscopy, a solid-state 532 run pulsed-KTP laser was used (15 ms pulse width, 5.25-7.5 J/pulse maximum output, 2 Hz repetition rate, 0.4 mm fiber, approximately 20-80 J/cm(2) fluence) to treat laryngeal papillomatosis. All patients underwent postoperative videolaryngoscopy to assess disease regression based on a previously used rating scale.Results: Thirty-seven patients underwent 55 procedures during the 18-month study period. Near-term follow-up with an early postoperative evaluation was available in 23 patients (35 procedures). Fourteen patients (20 procedures) were geographically distant and only returned after developing symptoms with significant disease recurrence. Of the 35 procedures in which near-term follow-up was available, 90% or greater disease regression was achieved in 28 of 35 (80%), 75% to 89% disease regression was achieved in 4 of 35 (11%), and 50% to 74% disease regression in 3 of 35 (9%). Anterior-commissure disease was present in 51 of 55 (93%) cases, and no new webbing/synechia occurred. All patients reported that their vocal function improved after treatment.Conclusions: The 532 mn pulsed-KTP laser was effective for treating recurrent respiratory papillomatosis, which was similar to our experience as an office-based procedure.