KTP Laser Safety and Efficacy in Benign Laryngeal Lesions

Abstract

Objective: The potassium titanyl phosphate (KTP) laser is increasingly used to treat polyps, granulomas, and similar laryngeal mucosal lesions and has been shown to be safe and effective in case series. In this study we introduce a method to quantify the safety and efficacy of the KTP laser in laryngeal procedures. Method: Pre-and post-KTP laser treatment videos were obtained from 3 institutions. The change in size of the laryngeal lesions was measured using a novel objective computerized method. A select number of videos were evaluated by blinded reviewers and rated for measures of safety. Results: More than 120 larynges underwent treatment for mucosal lesions including polyps, granulomas, and leukoplakia. Regardless of lesion type, there was a decrease in size based upon objective computer measurements, with all approaching or meeting statistical significance. Long-term follow-up was indicative of persistent lesion regression. Interrater reliability was good. Nineteen larynges were evaluated for safety based upon mucosal wave and glottic closure, with >90% of evaluations reporting preservation or improvement. Internal validity was good. Conclusion: KTP laser in laryngeal mucosal lesions is safe and effective based upon our safety rating instrument and computerized lesion measurement system. This system can be reliably used as an objective measure of lesion of regression post therapy and for scientific evaluation of KTP laser efficacy in laryngeal procedures.