KTP LASER SURGERY

KTP (potassium-titanyl phosphate) laser is an advanced treatment for the management of vocal fold lesions such as papilloma, leukoplakia, dysplasia, and cancer.

In Office Treatment for Papilloma

Now laryngeal diseases such as recurrent respiratory papillomatosis, can be treated in the office without need for sedation or an IV using a laser. This procedure takes twenty minutes to perform. Patients are able to drive themselves to and from the appointment, and not rely on others to take care of them afterwards. In fact, patients can return to work immediately after the procedure. A flexible laryngoscope is passed through a patient’s nose. Energy from the KTP laser is delivered through a fiber. This unique quality allows the surgeon to thread the fiber through an endoscope and deliver energy. Five minutes prior to the procedure the patient is asked to inhale aerosolized lidocaine, a topical numbing agent. This numbs the throat and voice box.

Most commonly a KTP laser fiber is used. The KTP laser is a “green-light” laser which emits energy that looks green in color. Energy from the KTP laser is preferentially absorbed by hemoglobin. Since papilloma is extremely vascular, or contains many blood vessels, the energy is ‘targeted’ towards the papilloma tissue. The KTP laser is not used to “cut” the papilloma out. Rather, the KTP laser is used more like a spray paint. After spraying all of the papilloma with laser energy, the papilloma turns from pink to white. After the KTP energy is absorbed by the papilloma, the papilloma dies and sloughs off leaving the normal tissue behind in many cases. Because the KTP laser selectively targets the papilloma the normal vocal cord tissue is preserved, allowing patients to more quickly return to a normal speaking voice. This is a unique quality which differentiates it from the standard carbon dioxide laser.

The traditional method of treatment is performed in the operating room with a patient asleep.

The pulsed dye laser is similar to the KTP laser. Both lasers preferentially target hemoglobin and have energy transmitted by a fiber. Either laser may be used in the operating room for traditional surgery or in the office for awake, unsedated, surgery.

Other treatments, such as cidofivir, Avastin or bevacizumab, may be employed by some physicians to help manage the papilloma. These treatments are not FDA-approved and considered off-label use of the medication.