Coblation plus photodynamic therapy (PDT) for the treatment of juvenile onset laryngeal papillomatosis: case reports

Abstract

BackgroundIn treating juvenile-onset laryngeal papillomatosis, the most difficult aspect is preventing recurrence. After a single treatment, recurrence can begin after as soon as 20 days and the recurrent rate can be higher than 90%. The causes of recurrence include the presence of mucosal cells infected with papilloma virus, which are undetectable with the naked eyes, and surgery-induced infection. Photodynamic therapy (PDT) could effectively solve this problem. Virus-infected cells have a very high metabolic energy for capturing and internalizing the photosensitizer, which, after light stimulation, subsequently induces active oxygen species inside the nucleus, which kill infected cells. The second generation of photosensitizer agents (PA) are locally applied to avoid the intravenous systemic damage caused by first-generation PAs, and this method is widely used for the treatment of genital warts to very good effect.MethodsWe used the photodynamic method to treat laryngeal papillomatosis in children and obtained significant efficacy. We followed three juvenile subjects with recurrent laryngeal papillomatosis through a course of treatment (each course includes three PDT sessions), with a follow-up after 6 months.ResultsThe characteristic procedures involve exposing the larynx with a laryngoscope and using low-temperature plasma technology to visualize the tumor resection, as the effects of plasma technology can reduce postoperative laryngeal edema and reduce intraoperative metastasis. PDT was performed during the first surgery, 20 days after and 30 days after surgery. At the 6-month follow-ups, there was no recurrence.ConclusionThis was the world's first successful reported case of the use of PDT treatment for juvenile laryngeal papillomatosis.

MVA E2 therapeutic vaccine for marked reduction in likelihood of recurrence of respiratory papillomatosis

“…This finding is concordant with previous reports of low-risk HPV 6 and 11 being the types of HPV most frequently detected in the larynx. 34 It is clear that recurrences occur in patients with RRP because of the persistence of HPV DNA. Because all patients were free of lesions after the initial treatment with MVA E2, biopsy samples were not taken for PCR analysis after the first round of injections.…”

Microscopic Surgery with Coblation for the Treatment of Benign Laryngeal Lesions: A Case Report

“…The characteristic procedures involve exposing the larynx with a laryngoscope and using low temperature plasma technology to visualize the tumor resection, as the effects of plasma technology can reduce post-operative laryngeal edema and reduce intraoperative metastasis [7].…”

Photodynamic therapy induces antifibrotic alterations in primary human vocal fold fibroblasts

“…At low concentrations, ROS can influence cell signaling . PDT has been used to treat laryngeal papillomas, precancerous lesions, and malignancies, and has achieved promising clinical results . Previous studies have reported that treatment of laryngeal carcinoma with PDT induced good healing of vocal folds.…”

“…A popular second‐generation photosensitizer, 5‐aminolevulinic acid (5‐ALA) has been used in the treatment of laryngeal keratosis and papillomatosis . We selected 5‐ALA as the photosensitizer in our study.…”