Comparative Effectiveness of Office‐Based 532‐nm Laser‐Assisted Vocal Polypectomy and Phonomicrosurgery: A Matched Cohort Study. (2nd September 2014)

• Record Type: Journal Article
• Authors: Cheng, Po‐Wen; Wang, Chi‐Te
• Is Part Of: Otolaryngology--head and neck surgery. Volume 151(2014)Supplement 1
• Page Start: P187
• Page End: P187
• Publication Date: 2014-09-02
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599814541629a156
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: Office‐based procedures, including indirect laryngoscopic surgery and angiolytic laser photocoagulation, have been proposed to treat hemorrhagic vocal polyps. Our previous research documented good treatment outcomes by combining the 2 aforementioned procedures (laser‐assisted vocal polypectomy [LAVP]). This study intends to further compare the effectiveness of LAVP with the gold standard of phonomicrosurgery. Methods: This study retrospectively enrolled 50 age‐, sex‐, and size‐matched patients of hemorrhagic vocal polyps treated by LAVP or phonomicrosurgery at a tertiary teaching hospital from January 2012 to October 2013. Treatment outcomes were evaluated before, 2 weeks after, and 6 weeks after the procedures via perceptual rating of voice quality, acoustic measurement of the speech signal, 10‐item voice‐handicap index (VHI‐10), maximal phonation time (MPT), subjective rating of voice quality, and videolaryngostroboscopic evaluations. Results: Both LAVP and phonomicrosurgery demonstrated significant improvements in most measuring parameters, 2 and 6 weeks postoperatively. Comparative effectiveness demonstrated similar objective outcomes (MPT, VHI‐10, perceptual, endoscopic, and acoustic analyses) between LAVP and phonomicrosurgery, while patients who received LAVP reported more symptomatic relief and higher subjective voice quality then phonomicrosurgery 2 weeks postoperatively. Six weeks after the procedures, both objective and subjective effectiveness revealed non‐significant differences between the 2 treatment groups. Conclusions: This study demonstrated that office‐based 532‐nm LAVP can be an effective, practical, and safe alternative treatment for small hemorrhagic vocal polyps. Patients who received LAVP experienced rapid symptomatic relief with higher subjective effectiveness than phonomicrosurgery, 2 weeks postoperatively. The overall treatment outcomes showed comparable effectiveness between LAVP and phonomicrosurgery.