Position Statement: In-Office Photoangiolytic Laser Treatment of Laryngeal Pathology

Photoangiolytic laser treatment, which is typically performed in an office or ambulatory setting under local or topical anesthesia with a flexible fiberoptic laryngoscope, is an established surgical treatment that is indicated for management of laryngeal pathologies including, but not limited to, vascular ectasias, polyps, leukoplakia,  papilloma, scar and neoplasms, both benign and malignant. Expert clinical experience and current peer reviewed literature show the procedure is effective in the management and treatment of laryngeal pathology.

Approved 3/2/2014

References:

1. Kuet, ML, Pitman, MJ. Photoangiolytic Laser Treatment of Recurrent Respiratory Papillomatosis: A Scaled Assessment Journal of Voice, Volume 27, Issue 1, Pages 124-128, January 2013.
2. Multi-institutional experience with the in-office potassium titanyl phosphate laser for laryngeal lesions. Sheu M, Sridharan S, Kuhn M, Wang S, Paul B, Venkatesan N, Fuller CW, Simpson CB, Johns M, Branski RC, Amin MR. J Voice. 2012 Nov;26(6):806-10.
3. Office-based laryngeal laser surgery with the 532-nm pulsed-potassium-titanyl-phosphate laser. Zeitels SM, Burns JA. Curr Opin Otolaryngol Head Neck Surg. 2007 Dec;15(6):394-400. Review.
4. Potassium titanyl phosphate laser treatment of intubation vocal granuloma. Lin DS, Cheng SC, Su WF. Eur Arch Otorhinolaryngol. 2008 Oct;265(10):1233-8. doi: 10.1007/s00405-008-0628-6. Epub 2008 Mar 4.
5. Office-based 532-nm pulsed KTP laser treatment of glottal papillomatosis and dysplasia. Koufman J., Ann Otol Rhinol Laryngol. 2007 Apr;116(4):317. No abstract available.
6. Office-based 532-nm pulsed KTP laser treatment of glottal papillomatosis and dysplasia. Zeitels SM, Akst LM, Burns JA, Hillman RE, Broadhurst MS, Anderson RR. Ann Otol Rhinol Laryngol. 2006 Sep;115(9):679-85.
7. Pulsed angiolytic laser treatment of ectasias and varices in singers. Zeitels SM, Akst LM, Bums JA, Hillman RE, Broadhurst MS, Anderson RR. Ann Otol Rhinol Laryngol. 2006 Aug;115(8):571-80.
8. Use of pulsed dye laser in the treatment of sulcus vocalis Hwang CS, Lee HJ, Ha JG, Cho CI, Kim NH, Hong HJ, Choi HS. Otolaryngol Head Neck Surg. 2013 May;148(5):804-9. doi: 10.1177/0194599813479909. Epub 2013 Feb 27.
9. Effect of the 532nm pulsed KTP laser in the treatment of Reinke’s edema. Pitman MJ, Lebowitz-Cooper A, Iacob C, Tan M. Laryngoscope. 2012 Dec;122(12):2786-92. doi: 10.1002/lary.23576. Epub 2012 Aug 8.
10. Office-based 585 nm pulsed dye laser treatment for vocal polyps. Kim HT, Auo HJ. Acta Otolaryngol. 2008 Sep;128(9):1043-7. doi: 10.1080/00016480701787828. PMID: 19086311
11. The use of the pulse dye laser in the treatment of vocal fold scar: a preliminary study. Mortensen MM, Woo P, Ivey C, Thompson C, Carroll L, Altman K. Laryngoscope. 2008 Oct;118(10):1884-8.
12. Patient tolerance of in-office pulsed dye laser treatments to the upper aerodigestive tract. Rees CJ, Halum SL, Wijewickrama RC, Koufman JA, Postma GN. Otolaryngol Head Neck Surg. 2006 Jun;134(6):1023-7.
13. 585-nm pulsed dye laser treatment of glottal dysplasia. Franco RA Jr, Zeitels SM, Farinelli WA, Faquin W, Anderson RR. Ann Otol Rhinol Laryngol. 2003 Sep;112(9 Pt 1):751-8.
14. 585-nm pulsed dye laser treatment of glottal papillomatosis. Franco RA Jr, Zeitels SM, Farinelli WA, Anderson RR. Ann Otol Rhinol Laryngol. 2002 Jun;111(6):486-92. 

Important Disclaimer Notice (Updated 7/31/14)

Position statements are approved by the American Academy of Otolaryngology—Head and Neck Surgery or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. Position statements are not intended to and should not be treated as legal, medical, or business advice.