Abstract：
Photodynamic therapy (PDT) is a minimally invasive method with strong tissue selectivity and nonthermal effects. We aim to investigate the efficacy of an in-office method utilizing PDT with local application of 5-aminolevulinic acid (ALA) and 635 nm diode laser for treating laryngeal leukoplakia.
Retrospective cohort study.
Outpatient clinic-tertiary medical center.
This study reviewed 32 patients with laryngeal leukoplakia, including 11 recurrent cases after surgery. All the procedures were performed in an office setting under topical anesthesia. Fifteen percent ALA solution was locally applied to the lesion through a flexible laryngoscope. Light illumination was performed using a 635 nm diode laser through a 400 μm optic fiber. The power density was 165 mW/cm2 to reach 100 J/cm2 . Results of laryngostroboscopy and voice evaluation during follow-up were collected.
The mean follow-up was 7.91 ± 4.83 (3-18) months. Thirty-nine procedures were performed, including 1 session for 27 patients, 2 sessions for 3 patients, and 3 sessions for 2 patients. The total response rate was 96.875% (31/32), including complete responses in 26 (81.25%) patients, partial responses in 5 patients (15.625%), and no response in 1 patient (3.125%). It appeared that PDT selectively eliminated the leukoplakia without affecting lamina propria and the surrounding normal mucosa remained unharmed. Scores of Voice Handicap Index-10, jitter, shimmer, and harmonic-to-noise ratio were significantly improved after PDT.
Office-based PDT is an effective, repeatable, and practical method for treating laryngeal leukoplakia. Local application of ALA is sufficient to achieve photodynamic reactions. PDT could eliminate laryngeal leukoplakia selectively while protecting the normal laryngeal structure.
Retrospective cohort study.
Outpatient clinic-tertiary medical center.
This study reviewed 32 patients with laryngeal leukoplakia, including 11 recurrent cases after surgery. All the procedures were performed in an office setting under topical anesthesia. Fifteen percent ALA solution was locally applied to the lesion through a flexible laryngoscope. Light illumination was performed using a 635 nm diode laser through a 400 μm optic fiber. The power density was 165 mW/cm2 to reach 100 J/cm2 . Results of laryngostroboscopy and voice evaluation during follow-up were collected.
The mean follow-up was 7.91 ± 4.83 (3-18) months. Thirty-nine procedures were performed, including 1 session for 27 patients, 2 sessions for 3 patients, and 3 sessions for 2 patients. The total response rate was 96.875% (31/32), including complete responses in 26 (81.25%) patients, partial responses in 5 patients (15.625%), and no response in 1 patient (3.125%). It appeared that PDT selectively eliminated the leukoplakia without affecting lamina propria and the surrounding normal mucosa remained unharmed. Scores of Voice Handicap Index-10, jitter, shimmer, and harmonic-to-noise ratio were significantly improved after PDT.
Office-based PDT is an effective, repeatable, and practical method for treating laryngeal leukoplakia. Local application of ALA is sufficient to achieve photodynamic reactions. PDT could eliminate laryngeal leukoplakia selectively while protecting the normal laryngeal structure.
摘要：
目的：光动力疗法（PDT）是一种微创方法，具有很强的组织选择性和非热效应。我们旨在研究使用PDT局部应用5-氨基乙酰丙酸（ALA）和635nm二极管激光治疗喉白斑的办公室方法的疗效。
方法：回顾性队列研究。
方法：门诊-三级医疗中心。
方法：本研究回顾了32例喉白斑患者，术后复发11例。所有程序均在局部麻醉下在办公室环境中进行。通过柔性喉镜将15％的ALA溶液局部应用于病变。使用635nm二极管激光器通过400μm光纤进行光照射。功率密度为165mW/cm2,达到100J/cm2。收集随访期间喉镜和语音评估的结果。
结果：平均随访7.91±4.83(3-18)个月。进行了39次手术，包括27名患者的1次会议，3名患者2次会议，为2名患者提供3次会议。总有效率为96.875%(31/32),包括26例（81.25%）患者的完全缓解，5例患者部分缓解（15.625%），1例患者无反应（3.125%）。似乎PDT选择性地消除了白斑，而不影响固有层，并且周围的正常粘膜没有受到伤害。语音障碍指数-10的分数，抖动，shimmer,PDT后谐波噪声比显著提高。
结论：基于办公室的PDT是一种有效的，可重复,治疗喉白斑的实用方法。ALA的局部应用足以实现光动力反应。PDT可以选择性地消除喉白斑，同时保护正常的喉结构。
方法：回顾性队列研究。
方法：门诊-三级医疗中心。
方法：本研究回顾了32例喉白斑患者，术后复发11例。所有程序均在局部麻醉下在办公室环境中进行。通过柔性喉镜将15％的ALA溶液局部应用于病变。使用635nm二极管激光器通过400μm光纤进行光照射。功率密度为165mW/cm2,达到100J/cm2。收集随访期间喉镜和语音评估的结果。
结果：平均随访7.91±4.83(3-18)个月。进行了39次手术，包括27名患者的1次会议，3名患者2次会议，为2名患者提供3次会议。总有效率为96.875%(31/32),包括26例（81.25%）患者的完全缓解，5例患者部分缓解（15.625%），1例患者无反应（3.125%）。似乎PDT选择性地消除了白斑，而不影响固有层，并且周围的正常粘膜没有受到伤害。语音障碍指数-10的分数，抖动，shimmer,PDT后谐波噪声比显著提高。
结论：基于办公室的PDT是一种有效的，可重复,治疗喉白斑的实用方法。ALA的局部应用足以实现光动力反应。PDT可以选择性地消除喉白斑，同时保护正常的喉结构。
