In-office angiolytic laser procedures are effective for vocal fold polyps, though with occasional occurrence of minor adverse events, according to a study published in JAMA Otolaryngology-Head & Neck Surgery.

 

In a retrospective cohort study, the research team led by Yu-Hsuan Lin, from the National Cheng Kung University in Tainan, Taiwan examined the outcomes and incidence rates of adverse events associated with in-office angiolytic laser procedures with or without concurrent polypectomy.

Th researchers identified 114 consecutive patients with vocal polyps who underwent in-office angiolytic laser treatments between 2014 and 2016. After the exclusion of 17 with missing or incomplete data, 97 were enrolled.

The mean duration of symptoms was 10.1 months (range, 1-60 months). Among 29 patients enrolled, 29 (30%) had angiolytic laser procedures only and 68 (70%) received laser with concurrent polypectomy.

Between 1 and 2 months after the surgical procedures, the researchers collected the following outcome data: videolaryngostroboscopy, a perceptual rating of voice quality, acoustic analysis, maximal phonation time, and subjective rating of voice quality using a visual analogue scale and 10-item voice handicap index.

The researchers observed significant improvements for both treatment modalities. They found only one patient (1%) receiving angiolytic laser with concurrent polypectomy underwent another treatment session.

So the need for multiple treatments was lower among patients receiving angiolytic laser with concurrent polypectomy versus those receiving laser treatment alone (1 vs. 21%; effect size, −1.57; 95% confidence interval, −2.77 to −0.36).

Eight adverse events were identified, including vocal fold edema, vocal hematoma, and vocal ulceration (five, two, and one event, respectively). Significantly fewer adverse events occurred among patients treated with laser plus concurrent polypectomy compared to those treated with angiolytic laser alone (3 vs. 21%; effect size, 1.2; 95% confidence interval, 0.26 to 2.13).

"In-office angiolytic laser procedures can be an effective alternative treatment for vocal polyps, although with possible need for multiple treatment sessions and occasional occurrence of minor postoperative adverse events," the authors wrote.

"Concurrent polypectomy following laser coagulation allows less laser energy delivery and reduces the risk of postoperative adverse events and the need for additional treatment sessions," the authors added.