In-Office KTP Treatment of Recurrent Respiratory Papillomatosis

KTP laser treatment of recurrent respiratory papillomatosis in the office

Small RRP lesions
Patient tolerance and/or preference

Bulky RRP lesions
Patient anxiety
Significant gag reflex
Medical comorbidities that contraindicate an in-office procedure

Aura XP laser
Flexible laryngoscope with a working channel
KTP laser fiber
KTP laser safety goggles

Patient sits in an upright position in a chair. Physician driving the laryngoscope stands on the patient¢s right side while the assistant, who passes the lidocaine drip catheter and laser fiber, stands on the patient¢s left.

Blood pressure and heart rate measurements before the procedure.

Good knowledge of the laryngeal anatomy
Knowledge of KTP laser treatment classifications:
KTP V ¢ Noncontact, angiolysis
KTP 1 ¢ Noncontact, epithelium intact
KTP 2 ¢ Noncontact, epithelium disruption
KTP 3 ¢ Select contact or noncontact, epithelial ablation without tissue removal
KTP 4 ¢ Contact, epithelial ablation with tissue removal

Vasovagal reaction, epistaxis, incomplete removal of RRP lesions, may require multiple procedures, anterior glottic web formation.

Vasovagal reaction, epistaxis, incomplete removal of RRP lesions, may require multiple procedures, anterior glottic web formation.

Zeitels SM, Akst LM, Burns JA, Hillman RE, Broadhurst MS, Anderson RR. Office-based 532-nm pulsed KTP laser treatment of glottal papillomatosis and dysplasia. Ann Otol Rhinol Laryngol. 2006; 115(9):679-85.
Zeitels SM, Burns JA. Office-based laryngeal laser surgery with the 532-nm pulsed-potassium-titanyl-phosphate laser. Curr Opin Otolaryngol Head Neck Surg. 2007;15(6):394-400.
Mallur PS, Johns III MM, Amin MR, Rosen CA. Proposed classification system for reporting 532-nm pulsed potassium titanyl phosphate laser treatment effects on vocal fold lesions. Laryngoscope 2014; 124: 1170-1175.
Dippoid S, Becker C, Nusseck M, Richter B, Echternach M. Narrow band imaging: a tool for endoscopic examination of patients with laryngeal papillomatosis. Ann Otol Rhinol Laryngol 2015; 124(11): 886-92.