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Efficacy, Tolerability and Safety of Operating Room Microlaryngoscopy Versus Office-Based Potassium Titanyl Phosphate (KTP) Laser Treatment of Benign Vocal Fold Lesions: A Longitudinal Prospective Evaluation of Multidimensional Voice Outcomes.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Efficacy, Tolerability and Safety of Operating Room Microlaryngoscopy Versus Office-Based Potassium Titanyl Phosphate (KTP) Laser Treatment of Benign Vocal Fold Lesions: A Longitudinal Prospective Evaluation of Multidimensional Voice Outcomes./
作者:	Chadwick, Keith Alan.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2020,
面頁冊數:	70 p.
附註:	Source: Masters Abstracts International, Volume: 82-04.
Contained By:	Masters Abstracts International82-04.
標題:	Surgery. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28030237
ISBN:	9798672165240

Efficacy, Tolerability and Safety of Operating Room Microlaryngoscopy Versus Office-Based Potassium Titanyl Phosphate (KTP) Laser Treatment of Benign Vocal Fold Lesions: A Longitudinal Prospective Evaluation of Multidimensional Voice Outcomes.
Chadwick, Keith Alan.

Efficacy, Tolerability and Safety of Operating Room Microlaryngoscopy Versus Office-Based Potassium Titanyl Phosphate (KTP) Laser Treatment of Benign Vocal Fold Lesions: A Longitudinal Prospective Evaluation of Multidimensional Voice Outcomes. - Ann Arbor : ProQuest Dissertations & Theses, 2020 - 70 p.

Source: Masters Abstracts International, Volume: 82-04.

Thesis (M.S.)--Weill Medical College of Cornell University, 2020.

This item must not be sold to any third party vendors.

INTRODUCTION: Benign vocal fold lesions (BVFLs) are common causes of dysphonia. Treatments for BVFLs include behavioral, medical and surgical interventions. The outcomes for both operating room excision of BVFLs with microlaryngoscopy under general anesthesia and office-based photoangiolysis with the potassium titanyl phosphate (KTP) laser in awake patients have been studied in the past. However, very limited data exist to directly compare these treatment modalities across a variety of voice outcomes.METHODS: A prospective study of adult patients with BVFLs undergoing surgical intervention in the operating room with microlaryngoscopy ("OR group") or in the office with the KTP laser ("KTP group") was performed. A multidimensional assessment of voice outcomes consisting of patient-reported outcome measures [Voice Handicap Index- 10 (VHI-10) and Singing VHI-10 (SVHI-10)], auditory perceptual measures [Consensus Auditory Perceptual Evaluation of Voice (CAPE-V)], ratings of videostroboscopic characteristics [Voice-Vibratory Assessment of Laryngeal Imaging (VALI)] and acoustic and aerodynamic measures was performed at baseline and intervals of 1-2 weeks, 1 month, 2 months and 3 months after intervention. The primary endpoint was the change in VHI-10 from baseline to 1 month after procedure. Secondary endpoints included VHI- 10 scores, SVHI-10 scores, CAPE-V ratings, VALI ratings and acoustic and aerodynamic measures at each time point. Differences after treatment were tested within groups using Wilcoxon signed-rank and McNemar-Bowker's tests. Differences between groups were tested with Fisher's exact tests, Kruskal-Wallis tests, Wilcoxon rank-sum (Mann-Whitney U) tests, Kaplan-Meier time-to-event analysis and growth curve modeling.RESULTS: 26 subjects completed the study-14 in the OR group and 12 in the KTP group. 65% of patients were male and the mean age was 37.15 years. The primary lesion type in all patients was vocal fold polyp. 3 patients also had fibrous mass(es), all in the OR group. 3 patients in the KTP group (25%) required a second KTP procedure. The mean VHI-10 significantly improved from baseline to each follow-up interval in both groups, with a lower mean VHI-10 score at 1-2 weeks in the KTP group. The mean SVHI-10 improved for both groups at some intervals. Growth curve models and time-to- event analyses for patient-reported outcomes did not differ between groups. There were significant improvements in all categories of auditory perceptual voice quality and some categories of videostroboscopic characteristics in both groups. There were no significant trends identified in acoustic and aerodynamic measures. Improvements in the majority of outcomes did not significantly differ between groups. 1 patient in the KTP group (8%) was unable to tolerate the procedure, and 1 patient in the OR group (7%) experienced glottic insufficiency. There were no major complications.CONCLUSION: Significant improvements in patient-reported voice outcomes measures, auditory perceptual voice evaluation and videostroboscopic characteristics occur following surgical treatment of BVFLs with either microlaryngoscopy or office- based KTP laser. Long-term voice outcomes do not significantly differ between treatment modalities.

ISBN: 9798672165240Subjects--Topical Terms:

707153
Surgery.
Subjects--Index Terms:

Benign vocal fold lesions

Efficacy, Tolerability and Safety of Operating Room Microlaryngoscopy Versus Office-Based Potassium Titanyl Phosphate (KTP) Laser Treatment of Benign Vocal Fold Lesions: A Longitudinal Prospective Evaluation of Multidimensional Voice Outcomes.
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245 1 0 $a Efficacy, Tolerability and Safety of Operating Room Microlaryngoscopy Versus Office-Based Potassium Titanyl Phosphate (KTP) Laser Treatment of Benign Vocal Fold Lesions: A Longitudinal Prospective Evaluation of Multidimensional Voice Outcomes.
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500 $a Source: Masters Abstracts International, Volume: 82-04.
500 $a Advisor: Imperato‐McGinley, Julianne;Zhu, Yuan-Shan.
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506 $a This item must not be sold to any third party vendors.
520 $a INTRODUCTION: Benign vocal fold lesions (BVFLs) are common causes of dysphonia. Treatments for BVFLs include behavioral, medical and surgical interventions. The outcomes for both operating room excision of BVFLs with microlaryngoscopy under general anesthesia and office-based photoangiolysis with the potassium titanyl phosphate (KTP) laser in awake patients have been studied in the past. However, very limited data exist to directly compare these treatment modalities across a variety of voice outcomes.METHODS: A prospective study of adult patients with BVFLs undergoing surgical intervention in the operating room with microlaryngoscopy ("OR group") or in the office with the KTP laser ("KTP group") was performed. A multidimensional assessment of voice outcomes consisting of patient-reported outcome measures [Voice Handicap Index- 10 (VHI-10) and Singing VHI-10 (SVHI-10)], auditory perceptual measures [Consensus Auditory Perceptual Evaluation of Voice (CAPE-V)], ratings of videostroboscopic characteristics [Voice-Vibratory Assessment of Laryngeal Imaging (VALI)] and acoustic and aerodynamic measures was performed at baseline and intervals of 1-2 weeks, 1 month, 2 months and 3 months after intervention. The primary endpoint was the change in VHI-10 from baseline to 1 month after procedure. Secondary endpoints included VHI- 10 scores, SVHI-10 scores, CAPE-V ratings, VALI ratings and acoustic and aerodynamic measures at each time point. Differences after treatment were tested within groups using Wilcoxon signed-rank and McNemar-Bowker's tests. Differences between groups were tested with Fisher's exact tests, Kruskal-Wallis tests, Wilcoxon rank-sum (Mann-Whitney U) tests, Kaplan-Meier time-to-event analysis and growth curve modeling.RESULTS: 26 subjects completed the study-14 in the OR group and 12 in the KTP group. 65% of patients were male and the mean age was 37.15 years. The primary lesion type in all patients was vocal fold polyp. 3 patients also had fibrous mass(es), all in the OR group. 3 patients in the KTP group (25%) required a second KTP procedure. The mean VHI-10 significantly improved from baseline to each follow-up interval in both groups, with a lower mean VHI-10 score at 1-2 weeks in the KTP group. The mean SVHI-10 improved for both groups at some intervals. Growth curve models and time-to- event analyses for patient-reported outcomes did not differ between groups. There were significant improvements in all categories of auditory perceptual voice quality and some categories of videostroboscopic characteristics in both groups. There were no significant trends identified in acoustic and aerodynamic measures. Improvements in the majority of outcomes did not significantly differ between groups. 1 patient in the KTP group (8%) was unable to tolerate the procedure, and 1 patient in the OR group (7%) experienced glottic insufficiency. There were no major complications.CONCLUSION: Significant improvements in patient-reported voice outcomes measures, auditory perceptual voice evaluation and videostroboscopic characteristics occur following surgical treatment of BVFLs with either microlaryngoscopy or office- based KTP laser. Long-term voice outcomes do not significantly differ between treatment modalities.
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