Angiolytic laser stripping versus CO2 laser microflap excision for vocal fold leukoplakia

Long-term disease control and voice outcomes

JaeYoul Lim, Young Min Park, Minsuk Kang, Seung Jin Lee, Kwangha Baek, Jina Na, Hong Shik Choi

Research output: Contribution to journalArticle

Abstract

Background and purpose Vocal fold leukoplakia, white plaque on the epithelium, has the potential for malignant transformation regardless of dysplasia grade. It is treated with different laser types (CO 2 or angiolytic) and various techniques (vaporization, stripping, or excision); however, only a few studies exist regarding comparative laser surgery results. This study was conducted to investigate clinical outcomes of CO 2 versus angiolytic laser microdissection with regard to long-term disease control and voice preservation in vocal fold leukoplakia. Materials and methods Seventy patients with vocal fold leukoplakia treated by CO 2 or angiolytic laser (pulsed dye laser or potassium titanyl phosphate) were identified retrospectively. Data regarding patient characteristics, treatment details, treatment outcomes including disease control (recurrence and progression) and the Voice Handicap Index, GRBAS scale, and acoustics were evaluated. The mean follow-up duration after initial treatment was 32 ± 26 months. Results The study group comprised 14 patients who underwent CO 2 laser microflap excision and 56 who underwent angiolytic laser stripping. Of the patients treated with CO 2 laser, 11 (79%) had no recurrence and three (21%) showed recurrent leukoplakia, of which one patient (7%) showed histologic grade progression. Of patients who underwent angiolytic laser stripping, 12 had disease recurrence (21%), among whom three (5%) showed disease progression. Laser surgery type, disease extent, and histologic grade showed no significant differences in recurrence or progression rates. The postoperative Voice Handicap Index significantly improved (P = .03) and the G score significantly decreased (P < .001) in the angiolytic laser treatment group. In contrast, the Voice Handicap Index increased postoperatively in the CO 2 laser group (P = .046). Conclusions The long-term recurrence or progression rates were not significantly different between angiolytic and CO 2 laser treatment. The angiolytic laser stripping group showed better voice preservation compared with the CO 2 laser group. Angiolytic laser stripping is suggested as an effective treatment option for vocal fold leukoplakia with comparable disease control and better voice preservation.

Original languageEnglish
Article numbere0209691
JournalPloS one
Volume13
Issue number12
DOIs
Publication statusPublished - 2018 Dec 1

Fingerprint

Disease control
Leukoplakia
Gas Lasers
Vocal Cords
lasers
disease control
Lasers
Carbon Monoxide
Recurrence
Laser surgery
laser surgery
Laser Therapy
Microdissection
Dye Lasers
Therapeutics
Dye lasers
Volatilization
potassium phosphates
Pulsed lasers
Vaporization

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Lim, JaeYoul ; Park, Young Min ; Kang, Minsuk ; Lee, Seung Jin ; Baek, Kwangha ; Na, Jina ; Choi, Hong Shik. / Angiolytic laser stripping versus CO2 laser microflap excision for vocal fold leukoplakia : Long-term disease control and voice outcomes. In: PloS one. 2018 ; Vol. 13, No. 12.
@article{5899458c919e4747b44b98364a7caa5e,
title = "Angiolytic laser stripping versus CO2 laser microflap excision for vocal fold leukoplakia: Long-term disease control and voice outcomes",
abstract = "Background and purpose Vocal fold leukoplakia, white plaque on the epithelium, has the potential for malignant transformation regardless of dysplasia grade. It is treated with different laser types (CO 2 or angiolytic) and various techniques (vaporization, stripping, or excision); however, only a few studies exist regarding comparative laser surgery results. This study was conducted to investigate clinical outcomes of CO 2 versus angiolytic laser microdissection with regard to long-term disease control and voice preservation in vocal fold leukoplakia. Materials and methods Seventy patients with vocal fold leukoplakia treated by CO 2 or angiolytic laser (pulsed dye laser or potassium titanyl phosphate) were identified retrospectively. Data regarding patient characteristics, treatment details, treatment outcomes including disease control (recurrence and progression) and the Voice Handicap Index, GRBAS scale, and acoustics were evaluated. The mean follow-up duration after initial treatment was 32 ± 26 months. Results The study group comprised 14 patients who underwent CO 2 laser microflap excision and 56 who underwent angiolytic laser stripping. Of the patients treated with CO 2 laser, 11 (79{\%}) had no recurrence and three (21{\%}) showed recurrent leukoplakia, of which one patient (7{\%}) showed histologic grade progression. Of patients who underwent angiolytic laser stripping, 12 had disease recurrence (21{\%}), among whom three (5{\%}) showed disease progression. Laser surgery type, disease extent, and histologic grade showed no significant differences in recurrence or progression rates. The postoperative Voice Handicap Index significantly improved (P = .03) and the G score significantly decreased (P < .001) in the angiolytic laser treatment group. In contrast, the Voice Handicap Index increased postoperatively in the CO 2 laser group (P = .046). Conclusions The long-term recurrence or progression rates were not significantly different between angiolytic and CO 2 laser treatment. The angiolytic laser stripping group showed better voice preservation compared with the CO 2 laser group. Angiolytic laser stripping is suggested as an effective treatment option for vocal fold leukoplakia with comparable disease control and better voice preservation.",
author = "JaeYoul Lim and Park, {Young Min} and Minsuk Kang and Lee, {Seung Jin} and Kwangha Baek and Jina Na and Choi, {Hong Shik}",
year = "2018",
month = "12",
day = "1",
doi = "10.1371/journal.pone.0209691",
language = "English",
volume = "13",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "12",

}

Angiolytic laser stripping versus CO2 laser microflap excision for vocal fold leukoplakia : Long-term disease control and voice outcomes. / Lim, JaeYoul; Park, Young Min; Kang, Minsuk; Lee, Seung Jin; Baek, Kwangha; Na, Jina; Choi, Hong Shik.

In: PloS one, Vol. 13, No. 12, e0209691, 01.12.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Angiolytic laser stripping versus CO2 laser microflap excision for vocal fold leukoplakia

T2 - Long-term disease control and voice outcomes

AU - Lim, JaeYoul

AU - Park, Young Min

AU - Kang, Minsuk

AU - Lee, Seung Jin

AU - Baek, Kwangha

AU - Na, Jina

AU - Choi, Hong Shik

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background and purpose Vocal fold leukoplakia, white plaque on the epithelium, has the potential for malignant transformation regardless of dysplasia grade. It is treated with different laser types (CO 2 or angiolytic) and various techniques (vaporization, stripping, or excision); however, only a few studies exist regarding comparative laser surgery results. This study was conducted to investigate clinical outcomes of CO 2 versus angiolytic laser microdissection with regard to long-term disease control and voice preservation in vocal fold leukoplakia. Materials and methods Seventy patients with vocal fold leukoplakia treated by CO 2 or angiolytic laser (pulsed dye laser or potassium titanyl phosphate) were identified retrospectively. Data regarding patient characteristics, treatment details, treatment outcomes including disease control (recurrence and progression) and the Voice Handicap Index, GRBAS scale, and acoustics were evaluated. The mean follow-up duration after initial treatment was 32 ± 26 months. Results The study group comprised 14 patients who underwent CO 2 laser microflap excision and 56 who underwent angiolytic laser stripping. Of the patients treated with CO 2 laser, 11 (79%) had no recurrence and three (21%) showed recurrent leukoplakia, of which one patient (7%) showed histologic grade progression. Of patients who underwent angiolytic laser stripping, 12 had disease recurrence (21%), among whom three (5%) showed disease progression. Laser surgery type, disease extent, and histologic grade showed no significant differences in recurrence or progression rates. The postoperative Voice Handicap Index significantly improved (P = .03) and the G score significantly decreased (P < .001) in the angiolytic laser treatment group. In contrast, the Voice Handicap Index increased postoperatively in the CO 2 laser group (P = .046). Conclusions The long-term recurrence or progression rates were not significantly different between angiolytic and CO 2 laser treatment. The angiolytic laser stripping group showed better voice preservation compared with the CO 2 laser group. Angiolytic laser stripping is suggested as an effective treatment option for vocal fold leukoplakia with comparable disease control and better voice preservation.

AB - Background and purpose Vocal fold leukoplakia, white plaque on the epithelium, has the potential for malignant transformation regardless of dysplasia grade. It is treated with different laser types (CO 2 or angiolytic) and various techniques (vaporization, stripping, or excision); however, only a few studies exist regarding comparative laser surgery results. This study was conducted to investigate clinical outcomes of CO 2 versus angiolytic laser microdissection with regard to long-term disease control and voice preservation in vocal fold leukoplakia. Materials and methods Seventy patients with vocal fold leukoplakia treated by CO 2 or angiolytic laser (pulsed dye laser or potassium titanyl phosphate) were identified retrospectively. Data regarding patient characteristics, treatment details, treatment outcomes including disease control (recurrence and progression) and the Voice Handicap Index, GRBAS scale, and acoustics were evaluated. The mean follow-up duration after initial treatment was 32 ± 26 months. Results The study group comprised 14 patients who underwent CO 2 laser microflap excision and 56 who underwent angiolytic laser stripping. Of the patients treated with CO 2 laser, 11 (79%) had no recurrence and three (21%) showed recurrent leukoplakia, of which one patient (7%) showed histologic grade progression. Of patients who underwent angiolytic laser stripping, 12 had disease recurrence (21%), among whom three (5%) showed disease progression. Laser surgery type, disease extent, and histologic grade showed no significant differences in recurrence or progression rates. The postoperative Voice Handicap Index significantly improved (P = .03) and the G score significantly decreased (P < .001) in the angiolytic laser treatment group. In contrast, the Voice Handicap Index increased postoperatively in the CO 2 laser group (P = .046). Conclusions The long-term recurrence or progression rates were not significantly different between angiolytic and CO 2 laser treatment. The angiolytic laser stripping group showed better voice preservation compared with the CO 2 laser group. Angiolytic laser stripping is suggested as an effective treatment option for vocal fold leukoplakia with comparable disease control and better voice preservation.

UR - http://www.scopus.com/inward/record.url?scp=85059264214&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059264214&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0209691

DO - 10.1371/journal.pone.0209691

M3 - Article

VL - 13

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 12

M1 - e0209691

ER -