Microsurgery of chronic laryngeal diseases using fiber optic lasers. A review
- Authors: Krivopalov A.A.1,2, Shamkina P.A.2, Glushchenko A.I.2
-
Affiliations:
- Mechnikov North-Western State Medical University
- Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
- Issue: Vol 25, No 9 (2023): Otorhinolaryngology and pulmonology
- Pages: 642-647
- Section: Articles
- URL: https://journals.rcsi.science/2075-1753/article/view/253582
- DOI: https://doi.org/10.26442/20751753.2023.9.202418
- ID: 253582
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Abstract
Background. The treatment of chronic diseases of the larynx is an urgent issue. Chronic larynx masses account for up to 55–70% of the upper respiratory tract proliferative diseases. The incidence of vocal apparatus disorders is stable due to increased load on the vocal apparatus, neuro-emotional stress, non-compliance with voice hygiene (smoking, alcohol consumption), nasal and pharyngeal inflammatory diseases, sensibilization, and gastrointestinal disorders. Dysphonia, voice timbre changes, and vocal fatigue are presented in 7–12% of otorhinolaryngologist patients. Delayed treatment of chronic larynx diseases can lead to upper respiratory obstruction, reduced exercise and self-care tolerance, and disablement in people with voice and speech professions.
Aim. To address current treatment methods for chronic diseases of the larynx. Modern surgical and non-surgical treatments of chronic larynx diseases aim to restore voice quality and respiratory function. Over the past 50 years, laser-assisted phonosurgery has gained popularity due to the many benefits of biological tissue exposure to electromagnetic energy and low rates of intra- and postoperative complications.
Materials and methods. The literature review was performed using electronic medical libraries and professional printed papers. According to local and foreign data, laryngeal laser surgery is highly precise, minimally invasive, associated with no blood loss, and highly effective. Historically, CO2 laser has been used for the longest time in laryngeal surgery. Modern medical technology has recently introduced surgical systems with novel technicalities for clinical use. In such devices, the laser energy is transmitted through a flexible optical fiber instead of a mirror system, as in the CO2 laser, which has made new surgical high-energy systems more affordable for equipping medical institutions. Currently, the following fiber-optic laser systems are most often used to treat chronic diseases of the larynx: potassium-titanyl-phosphate, diode laser, and "blue" laser with a wavelength of 445 nm.
Results. The literature review and analysis of surgical treatment outcomes using fiber-optic laser devices in patients with chronic larynx diseases showed high safety and effectiveness of modern treatments, providing fast recovery of voice and respiratory function.
Conclusion. The development of laser devices, including domestic ones, with new wavelengths, makes it possible to work in contact mode in an inert gas environment, which opens up new opportunities for phonosurgery.
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##article.viewOnOriginalSite##About the authors
Aleksandr A. Krivopalov
Mechnikov North-Western State Medical University; Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Author for correspondence.
Email: Krivopalov@list.ru
ORCID iD: 0000-0002-6047-4924
D. Sci. (Med.), Mechnikov North-Western State Medical University, Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Russian Federation, Saint Petersburg; Saint PetersburgPolina A. Shamkina
Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Email: p.s.ent@bk.ru
ORCID iD: 0000-0003-4595-365X
Cand. Sci. (Med.), Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Russian Federation, Saint PetersburgAlexandra I. Glushchenko
Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Email: nocturne4@mail.ru
ORCID iD: 0000-0001-5209-7869
Graduate Student, Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Russian Federation, Saint PetersburgReferences
- Крюков А.И., Царапкин Г.Ю., Арзамазов С.Г., и др. Лазеры в оториноларингологии. Вестник оториноларингологии. 2016;6:62-6 [Kryukov AI, Tsarapkin GYu, Arzamasov SG, Panasov SA. The application of lasers in otorhinolaryngology. Vestnik otorinolaringologii. 2016;6:62-6 (in Russian)]. doi: 10.17116/otorino20168162-66
- Zediker MS, Zucker E. High-Power Diode Laser Technology. SPIE; Bellingham, WA, USA, 2022. High-power diode laser technology XX: A retrospective on 20 years of progress. Bellingem, 2022. doi: 10.1117/12.2615260
- Kaifuchi Y, Yoshida K, Yamagata Y, et al. High-Power Diode Laser Technology. Enhanced power conversion efficiency in 900-nm range single emitter broad stripe laser diodes maintaining high power operability. SPIE; Bellingham, WA, USA, 2019. doi: 10.1117/12.2509184
- Han L, Wang Z, Gordeev NY, et al. Progress of Edge-Emitting Diode Lasers Based on Coupled-Waveguide Concept. Micromachines (Basel). 2023;14(6):1271. doi: 10.3390/mi14061271
- Ракунова Е.Б. Современные возможности лечения пациентов с доброкачественными и опухолеподобными заболеваниями гортани. Вестник оториноларингологии. 2017;1:68-72. Режим доступа: https://www.elibrary.ru/item.asp?id=2934736266. Ссылка активна на 01.09.2023 [Rakunova EB. Modern treatment options for patients with benign and tumor-like diseases of the larynx. Bulletin of Otorhinolaryngology. 2017;1:68-72. Available at: https://www.elibrary.ru/item.asp?id=2934736266. Accessed: 01.09.2023 (in Russian)].
- Подкопаева Ю.Ю., Кривопалов А.А. Клинико-экспериментальное обоснование применения диодного лазера 980 нм в эндоларингеальной хирургии: материалы IV Петербургского форума оториноларингологов России. СПб., 2015; c. 393-4. Режим доступа: https://www.elibrary.ru/item.asp?id=39548422. Ссылка активна на 01.09.2023 [Podkopaeva YuYu, Krivopalov AA. Clinical and experimental rationale for the use of a 980 nm diode laser in endolaryngeal surgery: materials of the IV St. Petersburg Forum of Otorhinolaryngologists of Russia. Saint Petersburg, 2015; p. 393-4. Available at: https://www.elibrary.ru/item.asp?id=39548422. Accessed: 01.09.2023 (in Russian)].
- Arroyo HH, Neri L, Fussuma CY, et al. Diode-Laser for Laryngeal Surgery: a Systematic Review. Int Arch Otorhinolaryngol. 2016;20(2):172-9. doi: 10.1055/s-0036-1579741
- Roy N, Merrill RM, Gray SD, Smith EM. Voice disorders in the general population: prevalence, risk factors, and occupational impact. Laryngoscope. 2005;115(11):1988-995. doi: 10.1097/01.mlg.0000179174.32345.41
- Lee YS, Lee DH, Jeong GE, et al. Treatment efficacy of voice therapy for vocal fold polyps and factors predictive of its efficacy. J Voice. 2017;31(1):120.e9-13 doi: 10.1016/j.jvoice.2016.02.014
- Crump P, Wenzel H, Erbert G, Tränkle G. High-Power Diode Laser Technology and Applications. SPIE; Bellingham, WA, USA, 2012. Progress in increasing the maximum achievable output power of broad area diode lasers. doi: 10.1117/12.905250
- Sridharan S, Achlatis S, Ruiz R, et al. Patient-based outcomes of in-office KTP ablation of vocal fold polyps. Laryngoscope. 2014;124(5):1176-9. doi: 10.1002/lary.24442
- Ma J, Fang R, Zhen R, et al. A 532-nm KTP Laser for Vocal Fold Polyps: Efficacy and Relative Factors. Ear Nose Throat J. 2021;100(1_suppl.):87S-93S. doi: 10.1177/0145561320946153
- Долгов О.И., Рогова Д.О. Опыт эндоскопического хирургического лечения паралитических стенозов гортани. Российская оториноларингология. 2015;1(74):49-54 [Dolgov OI, Rogova DO. Experience of endoscopic treatment of paralytic laryngeal stenosis. Rossiiskaia otorinolaringologiia. 2015;1(74):49-54 (in Russian)].
- Gocal WA, Tong JY, Maxwell PJ, Sataloff RT. Systematic Review of Recurrence Rates of Benign Vocal Fold Lesions Following Surgery. J Voice. 2022;S0892-1997(22)00321-6. doi: 10.1016/j.jvoice.2022.10.015
- Lechien JR, Burns JA, Akst M. The use of 532-Nanometerpulsed potassium-titanyl-phosphate (KTP) laser in laryngology: a systematic review of current indications, safety, and voice outcomes. Ear Nose Throat J. 2020:145561319899183. doi: 10.1177/0145561319899183
- Karkos PD, Koskinas IS, Triaridis S, Constantinidis J. Lasers in Οtolaryngology: A Laser Odyssey From Carbon Dioxide to True Blue. Ear Nose Throat J. 2021;100(1suppl.):1S-3S. doi: 10.1177/0145561320951681
- Hormann K, Baker-Schreyer A, Keilmann A, Biermann G, et al. Laryngology and Otology. Functional results after CO2 laser surgery compared with conventional phonosurgery. J Laryngol Otol. 1999;113:140-4. doi: 10.1017/s0022215100143397
- Dalal N, Urvish S, Ajay SS. Role of CO2-laser and Diode-laser in ENT. GCSMC J Med Sci. 2017;VI(I):27-31. Available at: https://journals.indexcopernicus.com/search/article?articleId=1656914. Accessed: 01.09.2023.
- Hamdan AL, Hosri J, Feghali PAR, et al. Office-based Blue Laser Therapy of Vocal Fold Polyps: A Cohort of 18 Patients: Blue Laser Therapy of Vocal Fold Polyps. Laryngoscope. 2023. doi: 10.1002/lary.30602
- Karkos PD, Koskinas I, Stavrakas M, Triaridis S. Diode Laser for Laryngeal Cancer: "980 nm" and Beyond the Classic CO2. Ear Nose Throat J. 2021;100(1suppl.):19S-23S. doi: 10.1177/0145561320932043
- Pitman MJ, Lebowitz-Cooper A, Iacob C, Tan M. Effect of the 532nm pulsed KTP laser in the treatment of Reinke's edema. Laryngoscope. 2012;122(12):2786-92. doi: 10.1002/lary.23576
- Jeon GH, Seon SW, Lee SW. Comparative Results of Vocal Fold Injury According to the Fiber-Based Laser in a Rabbit Vocal Fold Model. J Voice. 2023:S0892-1997(23)00029-2. doi: 10.1016/j.jvoice.2023.01.029
- Chieffe D, Kalos S, Bunting G, Hartnick C. Blue light laser recontouring for pediatric benign fibrovascular vocal fold lesions. Int Pediatr Otorhinolaryngol. 2023;170:111601. doi: 10.1016/j.ijporl.2023.111601
- Глущенко А.И., Кривопалов А.А., Панченков П.И., и др. Инновационная техника хирургического лечения заболеваний ВДП с использованием полупроводникового лазера 450 нм. Сб. трудов Межрегиональной научно-практической конференции оториноларингологов СКФО с международным участием посвященной 100-летию со дня рождения Расула Гамзатова 23 июня 2023 г. Под ред. Ю.А Джамалудинова. Махачкала: ИПЦ ДГМУ, 2023 [Glushchenko AI, Krivopalov AA, Panchenkov PI, et al. Innovatsionnaia tekhnika khirurgicheskogo lecheniia zabolevanii VDP s ispol'zovaniiem poluprovodnikovogo lazera 450 nm. Sb. trudov Mezhregional'noi nauchno-prakticheskoi konferentsii otorinolaringologov SKFO s mezhdunarodnym uchastiiem posviashchennoy 100-letiiu so dnia rozhdeniia Rasula Gamzatova 23 iyunia 2023 g. Pod red. IuA Dzhamaludinova. Makhachkala: IPTS DGMU, 2023 (in Russian)].
- Hess M, Fleischer S. Photoangiolytische Laser in der Laryngologie Photoangiolytic Lasers in Laryngology. Laryngorhinootologie. 2020;99(9):607-12. doi: 10.1055/a-1071-0410
- Ulmschneider C, Baker J, Vize I, Jiang J. Phonosurgery: A review of current methodologies. World J Otorhinolaryngol Head Neck Surg. 2020;7(4):344-53. doi: 10.1016/j.wjorl.2020.09.001
- Fornaini C, Merigo E, Rocca JP, et al. 450 nm Blue Laser and Oral Surgery: Preliminary ex vivo Study. J Contemp Dent Pract. 2016;17(10):795-800. doi: 10.5005/jp-journals-10024-1933
- Braun A, Kettner M, Berthold M, et al. Efficiency of soft tissue incision with a novel 445-nm semi-conductor laser. Lasers Med Sci. 2018;33(1):27-33. doi: 10.1007/s10103-017-2320-9
- Yan Y, Olszewski A.E, Hoffman M.R, et al. Use of lasers in laryngeal surgery. J Voice. 2010;24(1):102-9. doi: 10.1016/j.jvoice.2008.09.006
- Xiuwen J, Jianguo T. Endoscopic. Ho laser interstitial therapy for pharyngolaryngeal venous malformations in adults. Eur Arch Otorhinolaryngol. 2015;272(4):937-940. doi: 10.1007/s00405-014-3463-y
- Yang J, Xie Z, Seyler BC. Comparing KTP and CO2 laser excision for recurrent respiratory papillomatosis: A systematic review. Laryngoscope Investig Otolaryngol. 2022;7(4):970-81. doi: 10.1002/lio2.871
- Burns JA, Kobler JB, Heaton JT, et al. Predicting Clinical Efficacy of Photoangiolytic and Cutting Ablating Lasers using the Chick Chorioallantoic Membrane Model Implications for Endoscopic Voice Surgery journal. Laryngoscope. 2008. Available: https://link.springer.com/chapter/10.1007/978-1-4939-1758-7_5. Accessed: 01.09.2023.
- Liu S, Shao J. Surgical outcome of different surgical modalities for adult recurrent respiratory papillomatosis. Acta Otolaryngol. 2023;143(2):196-200. doi: 10.1080/00016489.2023.2169346
- Мустафаев Д.М., Ашуров З.М., Зенгер В.Г., и др. Возможности комбинированного использования Ho:YAG- и КТР-лазеров в хирургии доброкачественных образований гортани. Лазерная медицина. 2007;11(3):21-6. Режим доступа: https://www.elibrary.ru/item.asp?id=9548740. Ссылка активна на 01.09.2023 [Mustafaev DM, Ashurov ZM, Zenger VG, et al. Possibilities of combined use of Ho:YAG and KTP lasers in surgery of benign laryngeal formations. Laser Medicine. 2007;11(3):21-6. Available at: https://www.elibrary.ru/item.asp?id=9548740. Accessed: 01.09.2023 (in Russian)].
- Sheu M, Sridharan S, Kuhn MJ, et al. Multi-institutional experience with the in-office potassium titanyl phosphate laser for laryngeal lesions. Voice. 2012;26(6):806-10. doi: 10.1016/j.jvoice.2012.04.003
- Mao W, Zhen R, Zhang F, et al. Office-based 532-nm KTP laser as a therapeutic modality for recurrent laryngeal papillomatosis: efficacy and relative factors. Lasers Med Sci. 2023;38(1):119. doi: 10.1007/s10103-023-03763-9
- Zeitels SM, Burns JA. Office-based laryngeal laser surgery with local anesthesia. Curr Opin Otolaryngol Head Neck Surg. 2007;15:141-7. doi: 10.1097/MOO.0b013e3281574582
- Ma J, Zhao X, Zhen R, et al. Comparative Efficacy of the KTP Laser and Cold Steel in Office-Based Surgery for Oropharyngeal Papilloma. Ear Nose Throat J. 2021:1455613211053413. DOI:110.1177/01455613211053413
- Hung WC, Lo WC, Fang KM, et al. Longitudinal Voice Outcomes Following Serial Potassium Titanyl Phosphate Laser Procedures for Recurrent Respiratory Papillomatosis. Ann Otol Rhinol Laryngol. 2021;130(4):363-9. doi: 10.1177/0003489420950374
- Zeitels SM, Akst LM, Burns JA, et al. Office-based 532-nm pulsed KTP laser treatment of glottal papillomatosis and dysplasia. Ann Otol Rhinol Laryngol. 2006;115(9):679-85. DOI:110.1177/000348940611500905
- Xie X, Young J, Kost K, McGregor M. KTP 532 nm laser for laryngeal lesions. a systematic review. J Voice. 2013;27(2):245-9. doi: 10.1016/j.jvoice.2012.11.006
- Рябова М.А., Улупов М.Ю., Портнов Г.В Лазерная хирургия папилломатоза ЛОР-органов. Актуальные проблемы лазерной медицины. 2022:88-100. Режим доступа: https://www.elibrary.ru/item.asp?id=48821724. Ссылка активна на 01.09.2023 [Ryabova MA, Ulupov MYu, Portnov GV. Laser surgery for papillomatosis of the ENT organs. Current Problems of Laser Medicine. 2022:88-100. Available at: https://www.elibrary.ru/item.asp?id=48821724. Accessed: 01.09.2023 (in Russian)].
- Безотосный В.В., Бондарев В.Ю., Кривонос М.С., и др. Мощные лазерные диоды спектрального диапазона 808 нм и 980 нм. Краткие сообщения по физике ФИАН. 2010;5:25-7 [Bezotosny VV, Bondarev VYu, Krivonos MS, et al. Powerful laser diodes of the spectral range 808 nm and 980 nm. Brief Communications on Physics FIAN. 2010;5:25-7 (in Russian)]. doi: 10.1070/QE2009v039n03ABEH013979
- Москвин С.В. Эффективность лазерной терапии. Серия «Эффективная лазерная терапия». Т. 2. М. – Тверь: Триада, 2014; c. 66 [Moskvin SV. Effektivnost' lazernoi terapii. Seriia “Effektivnaia lazernaya terapiia”. T. 2. Moscow – Tver': Triada, 2014; p. 66 (in Russian)].
- Улупов М.Ю., Шумилова Н.А., Портнов Г.В., Малкова М.Е. Экспериментальное изучение действия диодного лазера с длиной волны 980 нм. Российская оториноларингология. 2015;Suppl. 1:119-22. Режим доступа: https://www.elibrary.ru/item.asp?edn=vbclmr. Ссылка активна на 01.09.2023 [Ulupov MYu, Shumilova NA, Portnov GV, Malkova ME. Experimental study of the action of a diode laser with a wavelength of 980 nm. Rossiiskaia Otorhinolaryngologia. 2015;Suppl. 1:119-22. Available at: https://www.elibrary.ru/item.asp?edn=vbclmr. Accessed: 01.09.2023 (in Russian)].
- Карпищенко С.А., Улупов М.Ю., Иванцов А.О., Малкова М.Е. Экспериментальное обоснование выбора режима лазерного излучения с длиной волны 980 нм для рассечения рубцов верхних дыхательных путей. Российская оториноларингология. 2020;19(2):38-41 [Karpishchenko SA, Ulupov MYu, Ivantsov AO, Malkova ME. Mode selection of laser radiation with a wavelength of 980 nm for dissection of upper airway scars. Experimental Study. Rossiiskaia Otorinolaringologiia. 2020;19(2):38-41 (in Russian)]. doi: 10.18692/1810-4800-2020-2-38-41
- Лапченко А.С. Опыт применения диодного лазера в хирургии гортани. Лазерная медицина. 2014;18(4):54-5. Режим доступа: https://www.elibrary.ru/item.asp?id=23328377. Ссылка активна на 01.09.2023 [Lapchenko AS. Experience of using diode laser in laryngeal surgery. Laser Medicine. 2014;18(4):54-5. Available at: https://www.elibrary.ru/item.asp?id=23328377. Accessed: 01.09.2023 (in Russian)].
- Карпищенко С.А., Рябова М.А., Улупов М.Ю., и др. Актуальные проблемы лазерной медицины: сборник научных трудов под редакцией Н.Н. Петрищева. СПб.: Международный общественный Фонд культуры и образования, 2016; c. 9-19. Режим доступа: https://www.elibrary.ru/item.asp?edn=weejtl. Ссылка активна на 01.09.2023 [Karpishchenko SA, Ryabova MA, Ulupov MYu, et al. Current problems of laser medicine: collection of scientific papers edited by NN Petrishchev. Saint Petersburg: International Public Foundation for Culture and Education, 2016; p. 9-19. Available at: https://www.elibrary.ru/item.asp?edn=weejtl. Accessed: 01.09.2023 (in Russian)].
- Карпищенко С.А., Рябова М.А. Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова. Лазерная хирургия рака гортани: опыт кафедры оториноларингологии ПСПБГМУ ИМ И.П. Павлова. Folia otorhinolaryngologiae et pathologiae respiratoriae. 2017;23(1):8-18 [Karpishchenko SA, Ryabova MA. Pervyi Sankt-Peterburgskii gosudarstvennyi meditsinskii universitet im. akad. IP Pavlova. Lazernaia khirurgiia raka gortani: opyt kafedry otorinolaringologii PSPBGMU IM IP Pavlova. Folia otorhinolaryngologiae et pathologiae respiratoriae. 2017;23(1):8-18 (in Russian)].
- Козырева Е.Е., Шамкина П.А., Ильина В.А., Чуфистова А.В. Экспериментальное исследование параметров и методик хирургического воздействия лазера с длиной волны излучения 445 нм. Российская оториноларингология. 2021;20(6):60-6 [Kozyreva EE, Shamkina PA, Il'ina VA, Chufistova AV. Eksperimental'noye issledovaniye parametrov i metodik khirurgicheskogo vozdeystviya lazera s dlinoy volny izlucheniya 445 nm. Rossiiskaia otorinolaringologiia. 2021;20(6):60-6 (in Russian)]. doi: 10.18692/1810-4800-2021-6-60-63
- Hess MM, Fleischer S, Ernstberger M. New 445 nm blue laser for laryngeal surgery combines photoangiolytic and cutting properties. Eur Arch Otorhinolaryngol. 2018;275(6):1557-67. doi: 10.1007/s00405-018-4974-8.9
- Miller BJ, Abdelhamid A, Karagama Y. Applications of Office-Based 445 nm Blue Laser Transnasal Flexible Laser Surgery: A Case Series and Review of Practice. Ear Nose Throat J. 2021;100(1suppl.):105S-12S. doi: 10.1177/0145561320960544
- Кривопалов А.А., Шамкина П.А., Панченко П.И. Клинические аспекты лазерной хирургии хронических заболеваний гортани. Голова и шея. 2022;10(4):30-40 [Krivopalov AA, Shamkina PA, Panchenko PI. Clinical aspects of laser surgery for chronic laryngeal diseases. Head and Neck. 2022;10(4):30-40 (in Russian)]. doi: 10.25792/HN.2022.10.4.30–40