Pulse dye and other laser treatments for vocal scar

Prufer, Neil; Woo, Peak; Altman, Kenneth W.

doi:10.1097/moo.0b013e32833f890d

Cited by 24 publications

(12 citation statements)

References 34 publications

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“…33 More recently, the role of the photoangiolytic laser in scar remodeling has been investigated. 34 While these are important treatment options, voice outcomes are inconsistent, 26,27 and some, such as microflap elevation, require general anesthesia and direct microlaryngoscopy with suspension. We report outcomes of office-based steroid injection, reflecting a general trend toward rendering treatment in the office rather than the operating room.…”

Section: Discussionmentioning

confidence: 99%

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Voice Outcomes following a Single Office‐Based Steroid Injection for Vocal Fold Scar

Young

Hoffman

Koszewski

et al. 2016

Otolaryngol.--head neck surg.

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Office-based steroid injection combined with voice therapy for mild/moderate vocal fold scar is associated with improved patient-reported and functional voice measures. These findings provide preliminary support for this approach. Importantly, the procedure is low risk and can be performed in the office, thus offering a simple treatment alternative to patients with a disorder that has traditionally been difficult to manage. Prospective studies evaluating the effects of multiple injections are warranted.

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Section: Discussionmentioning

confidence: 99%

“…33 More recently, the role of the photoangiolytic laser in scar remodeling has been investigated. 34…”

Section: Discussionmentioning

confidence: 99%

Voice Outcomes following a Single Office‐Based Steroid Injection for Vocal Fold Scar

Young

Hoffman

Koszewski

et al. 2016

Otolaryngol.--head neck surg.

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“…Collagen injections, in combination with CO 2 laser treatment of the scar, have been shown to increase glottal competence 36. Other forms of laser, such as pulse dye laser, have also been used to attempt to treat vocal fibrosis 37. Hepatocyte Growth Factor injected via microtubules has shown to decrease procollagen production in mouse models 38.…”

Section: Discussionmentioning

confidence: 99%

Radiation fibrosis of the vocal fold: From man to mouse

et al. 2012

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Objectives To characterize fundamental late tissue effects in the human vocal fold following radiation therapy. To develop a murine model of radiation fibrosis to ultimately develop both treatment and prevention paradigms. Design Translational study using archived human and fresh murine irradiated vocal fold tissue. Methods 1) Irradiated vocal fold tissue from patients undergoing laryngectomy for loss of function from radiation fibrosis were identified from pathology archives. Histomorphometry, immunohistochemistry, and whole-genome microarray as well as real-time transcriptional analyses was performed. 2) Focused radiation to the head and neck was delivered to mice in a survival fashion. One month following radiation, vocal fold tissue was analyzed with histomorphometry, immunohistochemistry, and real-time PCR transcriptional analysis for selected markers of fibrosis. Results Human irradiated vocal folds demonstrated increased collagen transcription with increased deposition and disorganization of collagen in both the thyroarytenoid muscle and the superficial lamina propria. Fibronectin were increased in the superficial lamina propria. Laminin decreased in the thyroarytenoid muscle. Whole genome microarray analysis demonstrated increased transcription of markers for fibrosis, oxidative stress, inflammation, glycosaminoglycan production and apoptosis. Irradiated murine vocal folds demonstrated increases in collagen and fibronectin transcription and deposition in the lamina propria. Transforming growth factor (TGF)-β increased in the lamina propria. Conclusion Human irradiated vocal folds demonstrate molecular changes leading to fibrosis that underlie loss of vocal fold pliability that occurs in patients following laryngeal irradiation. Irradiated murine tissue demonstrates similar findings, and this mouse model may have utility in creating prevention and treatment strategies for vocal fold radiation fibrosis.

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“…The use of angiolytic lasers has been reported to be effective in hypertrophic cutaneous scarring. Although the mechanism is unclear, it is hypothesized that angiolytic laser decreases angiogenesis during the proliferative phase of scar formation . In one case series, 10 of 11 patients treated with in‐office low‐energy PDL for VF scar had subjective voice improvement .…”

Section: Methodsmentioning

confidence: 99%

In‐office procedures for the treatment of benign vocal fold lesions in the awake patient: A contemporary review

et al. 2018

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Objectives To review available information regarding in‐office procedures for benign vocal fold lesions (BVFL). Methods PubMed term search on office/awake laryngeal procedures for any of the following specific lesions: Reinke's edema (RE), polyps, nodules, varices, vocal process granuloma, and vocal fold (VF) scar. Results In‐office ablative and nonablative laser procedures have been described for BVFL, including RE, polyps, varices, and granuloma. Fiber‐based lasers used include potassium titanyl phosphate, pulsed dye laser, and more recently CO2. In‐office intralesional steroid injection (ISI) for BVFL targets the inflammatory process involved with the lesion and may induce regression of polyps, nodules, RE, and granuloma. Botulinum toxin‐induced “voice rest” has been described as adjunctive treatment for refractory VF nodules or vocal process granuloma. Most in‐office techniques for treating BVFL rely on induction of lesion regression rather than complete lesion removal, as in conventional operative microsurgery. When treating VF scarring, in‐office procedures aim to alter the wound‐healing process; ISI targets the inflammatory phase and angiolytic lasers target the proliferative phase. Conclusion In‐office procedures for BVFL apply new technology that can potentially lower risk and cost. Although numerous case series have shown the potential of these procedures, data that thoroughly compares outcomes with those of microlaryngoscopic techniques is needed. Laryngoscope, 129:2131–2138, 2019

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Pulse dye and other laser treatments for vocal scar

Abstract: The pulsed dye and other lasers have shown effectiveness and potential in treating cutaneous and vocal scarring.

Cited by 24 publications

References 34 publications

Voice Outcomes following a Single Office‐Based Steroid Injection for Vocal Fold Scar

Voice Outcomes following a Single Office‐Based Steroid Injection for Vocal Fold Scar

Radiation fibrosis of the vocal fold: From man to mouse

In‐office procedures for the treatment of benign vocal fold lesions in the awake patient: A contemporary review

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