title: Office-based potassium titanyl phosphate laser-assisted endoscopic vocal polypectomy.
abstract: OBJECTIVE
  Vocal polyps are common exophytic laryngeal lesions that usually necessitate microscopic laryngeal surgery under general anesthesia. Office-based indirect laryngoscopic procedures provide an alternative management option and can be performed comfortably under flexible endoscopic guidance. Combining angiolytic potassium titanyl phosphate (KTP) laser treatment and flexible endoscopic polypectomy should alleviate the risks of surgery under general anesthesia and expedite lesion regression.
  
  
  OBJECTIVE
  To combine angiolytic KTP laser treatment and endoscopic polyp removal and to evaluate the clinical applicability, treatment outcomes, and adverse effects of office-based KTP laser-assisted vocal polypectomy.
  
  
  METHODS
  Case series of KTP laser treatment (n = 16) and KTP laser-assisted polypectomy (n = 20). Patients underwent pretreatment and 2- and 6-week posttreatment evaluation with videolaryngostroboscopy (VLS), maximal phonation time, and a 10-item voice handicap index. Perceptual (GRB [grade, roughness, breathiness] scale) and acoustic analyses were performed before and 6 weeks after treatment.
  
  
  METHODS
  Tertiary teaching hospital.
  
  
  METHODS
  Thirty-six outpatients with unilateral hemorrhagic vocal polyps.
  
  
  METHODS
  Under local anesthesia, the KTP laser fiber was passed through the working channel of the flexible laryngoscope to photocoagulate the microvasculature of the polyp in all patients. Removal of coagulated vocal polyp using a flexible, endoscopic, blunt-ended grasping forceps immediately after KTP laser application was performed in the polypectomy group.
  
  
  METHODS
  Results of VLS, maximal phonation time, 10-item voice handicap index, and perceptual and acoustic analyses.
  
  
  RESULTS
  Six weeks after KTP laser treatment with and without polypectomy, 19 and 12 patients, respectively, experienced complete recovery and much improvement of mucosal wave. Maximal phonation time and the voice handicap index improved significantly 2 weeks after KTP laser with polypectomy (P < .01), whereas significant improvements were noted 6 weeks postoperatively in both treatment groups (P < .05). Acoustic and perceptual analyses also revealed significant improvements in both study groups (P < .05). During follow-up, we did not notice significant adverse effects.
  
  
  CONCLUSIONS
  Potassium titanyl phosphate laser-assisted vocal polypectomy is a safe, practical, and effective alternative option to treat hemorrhagic vocal polyps in the outpatient department, offering comparable but earlier therapeutic effects than KTP laser alone.
authors.affiliation: Department of Otolaryngology–Head and Neck Surgery, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, Banciao District, New Taipei City, Taiwan.
authors.forename: Chi-Te
authors.initials: CT
authors.lastname: Wang
authors.forename: Tsung-Wei
authors.initials: TW
authors.lastname: Huang
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Liao
authors.forename: Wu-Chia
authors.initials: WC
authors.lastname: Lo
authors.forename: Mei-Shu
authors.initials: MS
authors.lastname: Lai
authors.forename: Po-Wen
authors.initials: PW
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D053844:Lasers, Solid-State; D008297:Male; D008875:Middle Aged; D010699:Phonation; D011127:Polyps / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014741:Video Recording; D014827:Vocal Cords / Q000473:pathology / Q000601:surgery*