Is serial in-office laser treatment for vocal fold (VF) leukoplakia effective for long-term disease control with minimal morbidity?
Serial outpatient potassium titanyl phosphate (KTP) or pulsed dye laser (PDL) treatment of VF leukoplakia is effective for disease control with minimal morbidity and preservation of voice quality.
Explore this issue:July 2017
Background: Leukoplakia is a clinical diagnosis indicating the presence of keratin on the VF epithelial surface. This diagnosis portends a risk of malignant transformation, with the severity of dysplasia associated with an increased rate of malignant degeneration. The management of leukoplakia poses a clinical dilemma because leukoplakia carries with it a risk of malignant transformation regardless of dysplasia grade, and it often recurs after treatment. There is no consensus on treatment, with surgeons offering varying degrees and frequency of surveillance, differing thresholds for repeat biopsy, and options of repetitive ablative or excisional management. Recently, treatment with in-office laser has become a common strategy. Although there are studies demonstrating the efficacy of in-office laser treatment of VF leukoplakia, these works are often based on a small series that may not be specific to leukoplakia, do not employ serial treatment, have short-term follow-up, and do not use objective methods to quantify disease regression (See Figure 2).
Study design: Retrospective review (2008–2015).