Laryngeal sequelae secondary to surgical treatment for recurrent respiratory papillomatosis in children

Scatolini, María Laura; Labedz, Geraldine; Cocciaglia, Alejandro; Pérez, Cinthia Giselle; Nieto, Mary; D́Aquila, M. Rodríguez; Rodríguez, Hugo

doi:10.1016/j.ijporl.2019.109815

Cited by 8 publications

(13 citation statements)

References 17 publications

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“…The CO 2 laser—quickly gained popularity for treating RRP since the 1960s 14,18 . Many therapeutic options have also been advocated for RRP, such as microblade and PDL laser, but surgical removal using CO 2 laser remains the most important single treatment choice available 4,56,57 . Although the 10,600 nm wavelength of the CO 2 laser is well absorbed by water in biological tissue and is suitable for fine surgical cutting, its application to remove laryngeal lesions is not without risk 38,58 .…”

Section: Discussionmentioning

confidence: 99%

“…14 , 18 Many therapeutic options have also been advocated for RRP, such as microblade and PDL laser, but surgical removal using CO 2 laser remains the most important single treatment choice available. 4 , 56 , 57 Although the 10,600 nm wavelength of the CO 2 laser is well absorbed by water in biological tissue and is suitable for fine surgical cutting, its application to remove laryngeal lesions is not without risk. 38 , 58 Thermal injury, excessive resection, and repeated surgeries may result in a loss of pliable vocal fold tissue, fibrosis, and scar formation, which can significantly affect the voice and quality of life.…”

Section: Discussionmentioning

confidence: 99%

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Comparing KTP and CO₂ laser excision for recurrent respiratory papillomatosis: A systematic review

Yang

Xie

Seyler

2022

Laryngoscope Investig Oto

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Objective The CO2 laser and 532 nm potassium titanyl phosphate (KTP) laser have been applied to treat recurrent respiratory papillomatosis (RRP). This systematic review sought to compare outcome differences between these two methods. Data Sources Embase, Web of Science, PubMed, and the Cochrane Library. Review Methods CO2 laser and KTP laser studies were obtained by keyword searches of four authoritative medical databases. Articles were screened and retained when conforming to inclusion criteria. The primary outcome was cure rate; the secondary outcomes were recurrence, death, remission, clearance, and human papillomavirus (HPV)‐detected rates, as well as laser effectiveness rates. Postoperative complications rate was the safety outcome measure. All outcomes were summarized within the CO2 and KTP groups, with results statistically compared (p < .05). Results Overall, the cure rates were 87.25% (KTP group) and 75.98% (CO2 group; p < .05). Complication rates significantly differed between the KTP (2.32%) and CO2 (17.71%) groups (p < .0001). There was a relatively higher but not significant difference in the recurrence rates between the CO2 (18.6%) and KTP (10.87%) groups (p = .1595). The CO2 group remission rate was considerably lower (38.9%) than the KTP group (88.46%, p < .0001). HPV‐detected and clearance rates were only reported for the CO2 group. The bias risks were 13.1 ± 1.45 (CO2) and 13.6 ± 1.52 (KTP) for the two groups, indicating evidence was of fair quality. Conclusion Overall, KTP laser excision showed significantly better postoperative clinical outcomes than the CO2 laser, with a lower failure rate. Available fair‐quality evidence suggests KTP laser excision might be better for treating RRP. Nevertheless, more high‐quality randomized controlled studies are needed to compare these two surgical techniques, particularly in terms of reporting functional data such as vocal outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparing KTP and CO₂ laser excision for recurrent respiratory papillomatosis: A systematic review

Yang

Xie

Seyler

2022

Laryngoscope Investig Oto

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“…PAPAIOANNOU [14] believes that patients who undergo more surgeries are more likely to develop complications than patients with fewer surgeries. Scatolini [21] conducted a retrospective analysis of 74 patients with adolescent RRP and found that patients who had undergone more than 10 surgeries or who had previously had a history of surgery in an external institution had a higher frequency of throat scarring. However, El-Bitar [25] argued that the incidence of postoperative complications of RRP was related to the surgical technique used, not to the number of surgeries or the interval between surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, Rasmussende [20] argue that lasers are not optimal choice, in contrast to microdebriders that are simple to operate and result in less scar tissue. Scatolini [21] reported that a higher rate of sequelae was found in patients in whom laser was used together with microlaryngeal instruments. However, unlike the results of the studies mentioned above, Papaioannou supports the view that there is no significant difference in complications after conventional cold surgery and laser surgery [3] .…”

Section: Introductionmentioning

confidence: 99%

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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“…The CO 2 laser was firstly used in the 1960s and it quickly gained popularity for LP 14,18 . Many therapeutic options have been advocated for LP, such as microblade and PDL laser, but surgical removal using CO 2 laser remains the most important single treatment choice 4,54,55 . Although the 10 600 nm wavelength of the CO 2 laser is well absorbed by water in biological tissue and is suitable for fine surgical cutting, its application to remove laryngeal lesions is not without risk 56,57 .…”

Section: Discussionmentioning

confidence: 99%

Outcome Comparison of KTP laser and CO2 laser excision for Laryngeal papillomatosis -- A Systematic Review

Yang

Xie

2021

Preprint

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Background: CO2 laser and the 532-nm potassium titanyl phosphate laser (KTP) were developed to treat Laryngeal papillomatosis (LP); however, the difference in their outcomes remains unclear. Methods: A systematic review was conducted through a comprehensive search of three databases. Results: Overall, the cure rates were 87.25% in the KTP group and 75.98% in the CO2 group (p＜0.05). The complications rates were significantly different between the two groups (p<0.0001). In addition, there was no significant difference between the recurrence rates of the CO2 group and the KTP group (10% vs 9.8%). The risks of bias were 13.1±1.45 and 13.6±1.52 for CO2 group and KTP group respectively, which indicated the fair quality of evidence. Conclusions: The available fair-quality evidence suggested that KTP laser excision may be a better choice for LP. Following evaluations on the benefits of the two surgical techniques with more high-quality randomized controlled studies are needed.

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Laryngeal sequelae secondary to surgical treatment for recurrent respiratory papillomatosis in children

Cited by 8 publications

References 17 publications

Comparing KTP and CO₂ laser excision for recurrent respiratory papillomatosis: A systematic review

Comparing KTP and CO₂ laser excision for recurrent respiratory papillomatosis: A systematic review

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

Outcome Comparison of KTP laser and CO2 laser excision for Laryngeal papillomatosis -- A Systematic Review

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Laryngeal sequelae secondary to surgical treatment for recurrent respiratory papillomatosis in children

Cited by 8 publications

References 17 publications

Comparing KTP and CO2 laser excision for recurrent respiratory papillomatosis: A systematic review

Comparing KTP and CO2 laser excision for recurrent respiratory papillomatosis: A systematic review

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

Outcome Comparison of KTP laser and CO2 laser excision for Laryngeal papillomatosis -- A Systematic Review

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Comparing KTP and CO₂ laser excision for recurrent respiratory papillomatosis: A systematic review

Comparing KTP and CO₂ laser excision for recurrent respiratory papillomatosis: A systematic review