Photoangiolytic Laser Treatment of Recurrent Respiratory Papillomatosis: A Scaled Assessment

  • Mong-Loon Kuet
    School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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  • Michael J. Pitman
    Address correspondence and reprint requests to Michael J. Pitman, Voice and Swallowing Institute, Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary, 310 East 14th Street, New York, NY 10003.
    Voice and Swallowing Institute, Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary, New York, New York
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Published:October 29, 2012DOI:



      To investigate the effectiveness of unsedated office-based photoangiolytic laser surgery (UOLS) for treating recurrent respiratory papillomatosis (RRP) using the Derkay severity scale, Voice Handicap Index-10 (VHI-10), and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scale. Although previous studies examined the effect of UOLS on voice quality, few studies evaluated the effect on disease regression or used accepted and validated scales as outcome measures.

      Study Design

      Retrospective case series.


      Charts were reviewed for patients who underwent UOLS for RRP (2007–2010). Twenty-one patients met the inclusion criteria. Nineteen patients underwent treatment with a 532-nm potassium titanyl phosphate laser and two with a 585-nm pulsed dye laser. The Derkay, VHI-10, and GRBAS scores of posttreatment findings were compared with those of the pretreatment findings.


      Twenty-one patients underwent 81 office procedures. Mean follow-up was 18 months. From baseline to latest follow-up, there was significant improvement in the mean Derkay score from 6.1 to 3.0 (P=0.001), VHI-10 score from 24.5 to 15.9 (P=0.04), and GRBAS score from 8.6 to 4.9 (P=0.004).


      UOLS results in patient benefit from disease regression, reduced voice handicap, and improved voice quality without the risks associated with direct laryngoscopy and general anesthesia. UOLS is an effective, safe, nonexperimental treatment modality for RRP that has shifted the therapeutic paradigm while decreasing patient morbidity.

      Key Words

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