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KTP 레이저를 이용한 외래 기반 후두 수술의 임상적 적용

Clinical Applications of Office-Based Laryngeal Surgery With KTP Laser

  • 조정해 (가톨릭대학교 의과대학 이비인후과학교실)
  • Cho, Jung-Hae (Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea)
  • 투고 : 2021.12.01
  • 심사 : 2021.12.08
  • 발행 : 2021.12.31

초록

The pulsed photoangiolytic 532-nm potassium-titanyl-phosphate (KTP) laser has emerged in recent years as an efficacious treatment modality for vocal fold lesions. It also has broadened the indications for other laryngeal laser surgery. Features of KTP laser that it is a fiber-based delivery system and its energy is selectively absorbed by oxyhemoglobin make it suitable for office-based laryngeal procedures. An office-based KTP laser surgery provides an alternative management option for benign laryngeal diseases and can be performed comfortably under flexible endoscopic guidance which is placed through the nose of a fully awake patient. Office-based laryngeal surgery with a KTP laser can alleviate the need for general anesthesia. However, there are some limitations to apply due to reduced visual precision and the fact that the vocal folds are moving during procedures. Clinicians should carefully weigh the advantages and disadvantages of office-based procedures before a treatment option is selected. Patient selection and standardized laser energy parameters may help in decreasing complications and improving the treatment results.

키워드

참고문헌

  1. Tibbetts KM, Simpson CB. Office-based 532-nanometer pulsed potassium-titanyl-phosphate laser procedures in laryngology. Otolaryngol Clin North Am 2019;52(3):537-57. https://doi.org/10.1016/j.otc.2019.02.011
  2. Kim HT, Auo HJ. Office-based 585 nm pulsed dye laser treatment for vocal polyps. Acta Otolaryngol 2008;128(9):1043-7. https://doi.org/10.1080/00016480701787828
  3. Zeitels SM, Akst LM, Burns JA, Hillman RE, Broadhurst MS, Anderson RR. Office-based 532-nm pulsed KTP laser treatment of glottal papillomatosis and dysplasia. Ann Otol Rhinol Laryngol 2006;115(9):679-85. https://doi.org/10.1177/000348940611500905
  4. Ayala C, Selig M, Faquin W, Franco RA Jr. Ultrastructural evaluation of 585-nm pulsed-dye laser-treated glottal dysplasia. J Voice 2007;21(1):119-26. https://doi.org/10.1016/j.jvoice.2005.08.015
  5. Shoffel-Havakuk H, Sadoughi B, Sulica L, Johns MM 3rd. In-office procedures for the treatment of benign vocal fold lesions in the awake patient: A contemporary review. Laryngoscope 2019;129(9):2131-8. https://doi.org/10.1002/lary.27731
  6. Zeitels SM, Akst LM, Bums JA, Hillman RE, Broadhurst MS, Anderson RR. Pulsed angiolytic laser treatment of ectasias and varices in singers. Ann Otol Rhinol Laryngol 2006;115(8):571-80. https://doi.org/10.1177/000348940611500802
  7. Mallur PS, Johns MM 3rd, Amin MR, Rosen CA. Proposed classification system for reporting 532-nm pulsed potassium titanyl phosphate laser treatment effects on vocal fold lesions. Laryngoscope 2014;124(5):1170-5. https://doi.org/10.1002/lary.22451
  8. Del Signore AG, Shah RN, Gupta N, Altman KW, Woo P. Complications and failures of office-based endoscopic angiolytic laser surgery treatment. J Voice 2016;30(6):744-50. https://doi.org/10.1016/j.jvoice.2015.08.022
  9. Wang CT, Huang TW, Liao LJ, Lo WC, Lai MS, Cheng PW. Office-based potassium titanyl phosphate laser-assisted endoscopic vocal polypectomy. JAMA Otolaryngol Head Neck Surg 2013;139(6):610-6. https://doi.org/10.1001/jamaoto.2013.3052
  10. Wang CT, Liao LJ, Huang TW, Lo WC, Cheng PW. Comparison of treatment outcomes of transnasal vocal fold polypectomy versus microlaryngoscopic surgery. Laryngoscope 2015;125(5):1155-60. https://doi.org/10.1002/lary.25088
  11. Helman SN, Pitman MJ. Office-based 532-Nanometer pulsed potassium-titanyl-phosphate laser for marsupialization of laryngeal and vallecular mucoceles. Laryngoscope 2017;127(5):1116-8. https://doi.org/10.1002/lary.26173
  12. Karkos PD, George M, Van Der Veen J, Atkinson H, Dwivedi RC, Kim D, et al. Vocal process granulomas: A systematic review of treatment. Ann Otol Rhinol Laryngol 2014;123(5):314-20. https://doi.org/10.1177/0003489414525921
  13. Dominguez LM, Brown RJ, Simpson CB. Treatment outcomes of in-office KTP ablation of vocal fold granulomas. Ann Otol Rhinol Laryngol 2017;126(12):829-34. https://doi.org/10.1177/0003489417738790
  14. Fanjul-Velez F, Arce-Diego JL. Modeling thermotherapy in vocal cords novel laser endoscopic treatment. Lasers Med Sci 2008;23(2):169-77. https://doi.org/10.1007/s10103-007-0465-7
  15. Park YM, Lim JY, Kang MS, Choi HS. Treatment outcomes of angiolytic laser-assisted glottoplasty in patients with sulcus vocalis. Ann Otol Rhinol Laryngol 2019;128(5):377-83. https://doi.org/10.1177/0003489419826132
  16. Young VN, Mallur PS, Wong AW, Mandal R, Staltari GV, Gartner-Schmidt J, et al. Analysis of potassium titanyl phosphate laser settings and voice outcomes in the treatment of Reinke's edema. Ann Otol Rhinol Laryngol 2015;124(3):216-20. https://doi.org/10.1177/0003489414549155
  17. Koss SL, Baxter P, Panossian H, Woo P, Pitman MJ. Serial in-office laser treatment of vocal fold leukoplakia: Disease control and voice outcomes. Laryngoscope 2017;127(7):1644-51. https://doi.org/10.1002/lary.26445
  18. Young VN, Smith LJ, Sulica L, Krishna P, Rosen CA. Patient tolerance of awake, in-office laryngeal procedures: A multi-institutional perspective. Laryngoscope 2012;122(2):315-21. https://doi.org/10.1002/lary.22185
  19. Anderson J, Bensoussan Y, Townsley R, Kell E. In-office endoscopic laryngeal laser procedures: A patient safety initiative. Otolaryngol Head Neck Surg 2018;159(1):136-42. https://doi.org/10.1177/0194599818774511
  20. Lin YH, Wang CT, Lin FC, Liao LJ, Lo WC, Cheng PW. Treatment outcomes and adverse events following in-office angiolytic laser with or without concurrent polypectomy for vocal fold polyps. JAMA Otolaryngol Head Neck Surg 2018;144(3):222-30. https://doi.org/10.1001/jamaoto.2017.2899