Laser Treatment for Laryngeal Masses (PDL/KTP)
by Dr. Christopher Chang, last modified on
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Pulsed Dye Laser (PDL) and Potassium-Titanyl-Potassium (KTP) are new types of treatment to address masses found on the vocal cords without the need for general anesthesia. Treatment with PDL/KTP occurs in the office while awake. There is no cutting involved and pain is quite minimal. Just like undergoing fiberoptic laryngoscopy, a flexible endoscopic scope is passed through the nose and positioned above the voicebox. There is a channel in the scope through which a fiber containing the laser can be threaded through so that where the scope is looking, the laser can shoot at.
Once the scope and laser is positioned, the laser fires several times and appears much like the flash of a camera. The neat thing with PDL/KTP is that one doesn't have to "aim" the laser. Only where there is a high concentration of blood vessels is there an affect produced by the laser. As such, not all laryngeal masses can be addressed by PDL/KTP... only masses that are vascular such as hemorrhagic polyps, granulation tissue, large blood vessels, granulomas, papillomas, etc.
With treatment, the mass literally just melts away as the blood supply to the mass gets extinguished. The obvious advantage of this procedure over surgical excision is the fact that this can be done awake, unsedated, in an office setting without the need for any cutting. However, this very advantage can be a disadvantage in that a true "diagnosis" cannot be made (esp where cancer is a concern). A specimen is needed in order for a pathologist to analyze the mass under the microscope and unfortunately, the only way to obtain a specimen is to physically remove. Needless to say, PDL/KTP treatment does NOT treat cancer.
Below is a movie (Quicktime required) of a PDL treatment session being performed on a right hemorrhagic polyp. The movie and photo are provided courtesy of Dr. Chandra Marie Ivey. The pictures below were taken both before and 4 weeks later after the PDL treatment session on the same person. (Please note that the movie is a large file and may take a few minutes to load completely.)
Before PDL treatment
Appearance 4 weeks after PDL treatment.
Unfortunately, due to cost, this type of treatment is not available everywhere. Likely locations that may be able to provide this type of treatment option are at tertiary care centers with a large laryngology and voice disorders department (ie, Wake Forest University, George Washington University, etc).
In other words, our office unfortunately does not offer this type of treatment due to expense (though we certainly wish we had the capital to purchase one).
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