Applications of Office-Based 445 nm Blue Laser Transnasal Flexible Laser Surgery: A Case Series and Review of Practice

Miller, Benjamin J.; Abdelhamid, Amr; Karagama, Yakubu

doi:10.1177/0145561320960544

Cited by 33 publications

(26 citation statements)

References 30 publications

(48 reference statements)

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“…The recent introduction of blue laser to office-based laryngology presents potential advantages, which includes a desirable combination of cutting and photoangiolytic qualities and a lightweight, shock-resistant design. Miller [51] present a case series(thirty-six cases) and overview of office 445 nm blue laser transnasal flexible laser surgery, which support conclusion that blue laser is safe and effective in the treatment of RRP and a range of benign laryngeal lesions. Future research should compare the efficacy and safety of blue laser with potassium titanyl phosphate laser in office-based treatment of these conditions.…”

Section: Discussionsupporting

confidence: 55%

Safety of Different Surgical Modalities for Recurrent Respiratory Papillomatosis Resection: A Systematic Review and Meta-Analysis

Liu

Wang

Shao

2022

Preprint

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Background: Currently, the most common surgical modalities used for recurrent respiratory papillomatosis resection are microdebrider, CO2 laser, and KTP laser. However, complication rates vary among different surgical modalities and have been controversial in different studies. Objective of review: This study systematically reviews the available studies which reported intraoperative and postoperative complications, aiming to compare the safety of microdebrider, CO2 laser, and KTP laser. Type of review: Meta-analysis. Search strategy: Seven electronic databases (PubMed/MEDLINE, EMBASE[Ovid], Scopus, Cochrane Library, and Web of Science) were searched from inception through April 28th,2022. Randomized controlled, prospective or retrospective observational studies that recorded the complications of three different surgical modalities for recurrent respiratory papillomatosis resection were included in the meta-analysis. Evaluation method: Outcomes of interest were intraoperative and postoperative complications, and complication rate was calculated to evaluate the safety of surgical methods. Results: Twenty different studies was included in quantitative synthesis. Only one study compared outcomes of those three kinds of treatment modalities simultaneously, two studies compared microdebrider and CO2 laser, and the remaining studies focused on only one of three treatments. The weighted average complication rate for microdebrider was 0.03(95% confidence interval [CI] 0.00-0.21), n = 6, for CO2 laser treatment was 0.16 (95% confidence interval [CI] 0.09-0.25), n = 14，and for KTP laser treatment was 0.04 (95% CI 0.00-0.14), n =4. Conclusion：The limited evidence demonstrated that CO2 lasers in the surgical treatment of RRP may lead to more surgical complications, and microdebrider and KTP lasers may be safer. However, the heterogeneous data limits any strong comparison of outcomes of different treatment of laryngeal papillomas. Future randomised controlled trials that directly compare the safety of different surgical modalities are needed.

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Section: Discussionsupporting

confidence: 55%

Safety of Different Surgical Modalities for Recurrent Respiratory Papillomatosis Resection: A Systematic Review and Meta-Analysis

Liu

Wang

Shao

2022

Preprint

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“…The recent introduction of blue laser to office‐based laryngology presents potential advantages, which includes a desirable combination of cutting and photoangiolytic qualities and a lightweight, shock‐resistant design. Miller et al 50 present a case series (36 cases) and overview of office 445 nm blue laser transnasal flexible laser surgery, which support conclusion that blue laser is safe and effective in the treatment of RRP and several benign laryngeal lesions. Future research should compare the efficacy and safety of blue laser with KTP laser in office‐based treatment of these conditions.…”

Section: Discussionmentioning

confidence: 64%

Safety of different surgical modalities for recurrent respiratory papillomatosis resection: A systematic review and meta‐analysis

Liu

Wang

Shao

2023

Clinical Otolaryngology

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Background: Currently, the most common surgical modalities used for recurrent respiratory papillomatosis (RRP) resection are microdebrider, carbon dioxide (CO 2 ) laser and potassium-titanyl-phosphate (KTP) laser. However, complication rates vary among different surgical modalities and have been controversial in different studies.Objective of Review: This study systematically reviews the available studies which reported intra-operative and post-operative complications, aiming to compare the safety of microdebrider, CO 2 laser and KTP laser.

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“…In-office lasers procedures, usually performed with KTP or PDL lasers, and the newly introduced true-blue laser 2 , 20 , 22 , have offered an alternative to the traditional management under general anaesthesia. The glass fibre laser is inserted into the working channel of the video endoscope, thereby reducing costs and hospital stays, while giving the possibility to treat even small lesions that are not suitable for treatment under general anaesthesia 2 , 21 , 23 .…”

Section: Treatment Modalitiesmentioning

confidence: 99%

La papillomatosi laringea ricorrente: strategie terapeutiche multimodali. Revisione della letteratura e analisi retrospettiva multicentrica

Bertino¹,

Pedretti²,

Mauramati³

et al. 2023

Acta Otorhinolaryngol Ital

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SUMMARY Objectives Recurrent respiratory papillomatosis (RRP) is a benign, rare disease caused by Human Papilloma Virus (HPV) that can be divided into juvenile and adult forms. The course of the disease is variable, but is usually more aggressive in the juvenile form. The standard surgical treatment is represented by CO 2 laser resection, although photoangiolytic lasers represent a valid alternative. Adjuvant therapies have been proposed for disease control in case of frequent surgical resections or spreading into the lower airways. In recent years, the development of immunotherapy led to the use of bevacizumab either intratumorally or intravenously, but the most promising therapeutic development is represented by HPV vaccination. This paper aims to present a narrative review of the literature and the experience of three different University Centres in the treatment of RRP. Methods A retrospective analysis of the clinical charts of all patients affected by laryngeal papillomatosis and treated in three different University Centres between 2002 and 2022 was performed. The following parameters were collected: sex, age at first evaluation, sites of larynx involved, HPV type, type of first surgical treatment, presence and number of recurrences, surgical treatment of recurrences, adjuvant therapies, side effects and status at last follow-up. Results Seventy-eight patients were available for evaluation. Of these, 88% had adult onset RRP (Ao-RRP) and 12% juvenile onset RRP (Jo-RRP). The glottis was the most frequently involved subsite; all patients were submitted to surgical resection with CO 2 laser under general anaesthesia. Recurrences appeared in 79% of the patients, the patients who did not recur were all adults. The mean number of recurrences was 9 (range 1-110). Recurrences were more frequent in children (M = 20; range 2-110) than adults (M = 5; range 1-21). Thirty-two (52%) of the 62 patients who recurred were re-treated with CO 2 laser under general anaesthesia, while office-based treatment with a photoangiolytic laser was preferred in the remaining 30 (48%) patients. Adjuvant treatments were applied in 26 patients. The analysis of the course of the disease showed that in the 9 patients with Jo-RRP, 6 (67%) were free of lesions at the last follow-up, while the other 3 (33%) had papillomas. Of the 69 patients with Ao-RRP, 53 (77%) were alive and free of disease at the last visit, 14 (21%) were alive with disease, 1 (1%) was lost at follow-up and 1 (1%) died for other disease. Severe side effects were not observed except for 2 patients, who developed posterior glottic stenosis. Conclusions Our results confirmed the literature review. RRP is a potentially aggressive disease, especially in juvenile onset. Surgical resection is still first-line treatment, but in case of multiple recurrences the use of adjuvant therapies mus...

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Applications of Office-Based 445 nm Blue Laser Transnasal Flexible Laser Surgery: A Case Series and Review of Practice

Cited by 33 publications

References 30 publications

Safety of Different Surgical Modalities for Recurrent Respiratory Papillomatosis Resection: A Systematic Review and Meta-Analysis

Safety of Different Surgical Modalities for Recurrent Respiratory Papillomatosis Resection: A Systematic Review and Meta-Analysis

Safety of different surgical modalities for recurrent respiratory papillomatosis resection: A systematic review and meta‐analysis

La papillomatosi laringea ricorrente: strategie terapeutiche multimodali. Revisione della letteratura e analisi retrospettiva multicentrica

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