title: Analysis of Potassium Titanyl Phosphate Laser Settings and Voice Outcomes in the Treatment of Reinke's Edema.
abstract: OBJECTIVE
  Despite increased clinical utility of the 532-nm potassium titanyl phosphate (KTP) laser, no studies have examined outcomes for Reinke's edema (RE) as a function of laser parameters and initial treatment effects. Variability in delivery parameters, fiber-to-tissue distance, and immediate end-tissue effects limits universal application of existing study outcomes. We examine voice outcomes using standardized treatment classification, providing justification for laser parameter selection and immediate tissue effect in clinical use.
  
  
  METHODS
  Retrospective review of 9 patients who underwent KTP laser treatment for RE. Demographics, RE severity, laser settings, total laser energy, and immediate tissue effects were correlated with quantified voice outcomes.
  
  
  RESULTS
  An average of 157 joules (6-640 J) was delivered over a 0.369-second exposure time (0.1-0.9 seconds). Immediate tissue effects varied from nonablative treatment (type I and type II) to ablation without tissue removal (type III). Overall, Voice Handicap Index-10 (VHI-10) decreased by 8.23; improvement was most pronounced with type II treatments (delta VHI-10=12). No complications were encountered.
  
  
  CONCLUSIONS
  Potassium titanyl phosphate laser can be safely and effectively used to improve voice in RE patients regardless of severity. This is the first study to provide detailed information on laser settings, energy delivery, and treatment effect in RE management; these results may guide clinical use of this modality, especially for novice laser surgeons.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA youngvn@upmc.edu.
authors.forename: VyVy N
authors.initials: VN
authors.lastname: Young
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center, Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Pavan S
authors.initials: PS
authors.lastname: Mallur
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Adrienne W
authors.initials: AW
authors.lastname: Wong
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Rajarsi
authors.initials: R
authors.lastname: Mandal
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Giuseppe V
authors.initials: GV
authors.lastname: Staltari
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Jackie
authors.initials: J
authors.lastname: Gartner-Schmidt
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Clark A
authors.initials: CA
authors.lastname: Rosen
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D007819:Laryngeal Edema / Q000503:physiopathology / Q000532:radiotherapy*; D007828:Laryngoscopy / Q000379:methods; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D028022:Low-Level Light Therapy / Q000379:methods*; D010710:Phosphates; D014025:Titanium; D016896:Treatment Outcome; D014827:Vocal Cords / Q000503:physiopathology / Q000528:radiation effects*; D014833:Voice Quality / Q000502:physiology*
chemical_list: D010710:Phosphates; C064806:potassium titanylphosphate; D014025:Titanium
keywords: KTP; Reinke’s edema; laser; outcome; surgery; voice