Review Article|Articles in Press

Office-Based Laser Therapy in Vocal Fold Polyps: A Systematic Review and Meta-Analysis



      To analyze voice outcomes and lesion regression in patients with vocal fold polyps treated in-office using lasers.

      Study design

      Systematic review and meta-analysis.


      The search was performed in the Medline, Embase, and Cochrane databases using the preferred reporting items for systematic review and meta-analyses framework. There were no limitations to the year of publication and the search included studies looking at voice outcomes and lesion evolution of in-office laser treatment for vocal fold polyps measured through voice-handicap index, GRB, acoustic analysis or aerodynamics measures. Risk of bias was assessed using Cochrane's ROBINS-I tool for observational studies. Data analysis was performed SPSS software with a significance level of 5%.


      We identified 167 articles, 10 of which met the inclusion criteria and were analyzed. The total number of participants was 242. Meta-analysis showed significant improvement in voice handicap index-10 scores (95% CI, [0.86; 1.45]) and decrease in GRB score (95% CI, [1.09; 4.13]) after in-office laser therapy. It also showed significant improvement in percent shimmer (95% CI, [0.26; 1.01]), and significant increase in maximum phonation time (95% CI, [-0.92; -0.18]).


      Laser therapy an outpatient office setting is a reliable alternative to classical phono-microsurgery. Results show Office-based laser therapy of vocal fold polyps results in a significant improvement in subjective voice outcomes measures. This subjective improvement in voice quality is associated with partial or complete disease regression on laryngeal examination and an increase in maximum phonation time. Ovlaryngeal examination in patients with polyps treated with in-office laser.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Voice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Rosen CA
        • Gartner-Schmidt J
        • Hathaway B
        • et al.
        A nomenclature paradigm for benign midmembranous vocal fold lesions.
        Laryngoscope. 2012; 122: 1335-1341
        • Johns MM.
        Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps, and cysts.
        Curr Opin Otolaryngol Head Neck Surg. 2003; 11: 456-461
        • Martins RH
        • Defaveri J
        • Domingues MA
        • et al.
        Vocal polyps: clinical, morphological, and immunohistochemical aspects.
        J Voice: Off J Voice Foundation. 2011; 25: 98-106
        • Wang L
        • Tan JJ
        • Wu T
        • et al.
        Association between laryngeal pepsin levels and the presence of vocal fold polyps.
        Otolaryngol Head Neck Surg. 2017; 156: 144-151
        • Hamdan AL
        • Tabet G
        • Saadeddin Z
        • et al.
        Apoptosis in vocal fold polyps.
        J Voice: Off J Voice Foundation. 2018; 32: 104-108
      1. Sataloff RT. Sataloff's Comprehensive Textbook of Otolaryngolgy and Head and 83 Victoria St, London, Greater London, United Kingdom Neck Surgery. Sataloff RT, editor: Jaypee Brothers Medical Publishers; 2016.

        • Naunheim MR
        • Carroll TL.
        Benign vocal fold lesions: update on nomenclature, cause, diagnosis, and treatment.
        Curr Opin Otolaryngol Head Neck Surg. 2017; 25: 453-458
        • Petrovic-Lazic M
        • Jovanovic N
        • Kulic M
        • et al.
        Acoustic and perceptual characteristics of the voice in patients with vocal polyps after surgery and voice therapy.
        J Voice: Off J Voice Foundation. 2015; 29: 241-246
        • Zhuge P
        • You H
        • Wang H
        • et al.
        An analysis of the effects of voice therapy on patients with early vocal fold polyps.
        J Voice: Off J Voice Foundation. 2016; 30: 698-704
        • Sridharan S
        • Achlatis S
        • Ruiz R
        • et al.
        Patient-based outcomes of in-office KTP ablation of vocal fold polyps.
        Laryngoscope. 2014; 124: 1176-1179
        • Rosen CA
        • Lee AS
        • Osborne J
        • et al.
        Development and validation of the voice handicap index-10.
        Laryngoscope. 2004; 114: 1549-1556
        • Hirano
        Clinical Examination of Voice.
        Springer, New York1981
        • McGarey Jr., PO
        • Collins A
        • Dominguez LM
        • et al.
        Treatment of vocal fold polyps with in-office potassium titanyl phosphate (KTP) laser ablation in professional singers.
        J Voice: Off J Voice Foundation. 2021; 35: 800-803
        • Hamdan AL
        • Ghanem A.
        Un-sedated office-based application of blue laser in vocal fold lesions.
        J Voice: Off J Voice Foundation. 2021; (May 21;S0892-1997(21):00126-0. Online ahead of print. In press)
        • Ma J
        • Fang R
        • Zhen R
        • et al.
        A 532-nm KTP laser for vocal fold polyps: efficacy and relative factors.
        Ear Nose Throat J. 2021; 100 (1_suppl): 87s-93s
        • Hamdan AL
        • Khalifee E
        • Ghanem A.
        Application of thulium laser as office-based procedure in patients with vocal fold polyps.
        J Voice: Off J Voice Foundation. 2020; 34: 140-144
        • Lin YH
        • Wang CT
        • Lin FC
        • et al.
        Treatment outcomes and adverse events following in-office angiolytic laser with or without concurrent polypectomy for vocal fold polyps.
        JAMA Otolaryngol Head Neck Surg. 2018; 144: 222-230
        • Wang CT
        • Huang TW
        • Liao LJ
        • et al.
        Office-based potassium titanyl phosphate laser-assisted endoscopic vocal polypectomy.
        JAMA Otolaryngol Head Neck Surg. 2013; 139: 610-616
        • Ivey CM
        • Woo P
        • Altman KW
        • et al.
        Office pulsed dye laser treatment for benign laryngeal vascular polyps: a preliminary study.
        Ann Otol Rhinol Laryngol. 2008; 117: 353-358
        • Mizuta M
        • Hiwatashi N
        • Kobayashi T
        • et al.
        Comparison of vocal outcomes after angiolytic laser surgery and microflap surgery for vocal polyps.
        Auris Nasus Larynx. 2015; 42: 453-457
        • Kim HT
        • Auo HJ.
        Office-based 585 nm pulsed dye laser treatment for vocal polyps.
        Acta Otolaryngol. 2008; 128: 1043-1047
        • Hu HC
        • Lin SY
        • Hung YT
        • et al.
        Feasibility and associated limitations of office-based laryngeal surgery using carbon dioxide lasers.
        JAMA Otolaryngol Head Neck Surg. 2017; 143: 485-491
        • Lee YS
        • Lee DH
        • Jeong GE
        • et al.
        Treatment efficacy of voice therapy for vocal fold polyps and factors predictive of its efficacy.
        J Voice. 2017; 31: 120
        • Zhuge P
        • You H
        • Wang H
        • et al.
        An analysis of the effects of voice therapy on patients with early vocal fold polyps.
        J Voice. 2016; 30: 698-704
        • Omori K
        • Slavit DH
        • Matos C
        • et al.
        Vocal fold atrophy: quantitative glottic measurement and vocal function.
        Ann Otol Rhinol Laryngol. 1997; 106: 544-551
        • Omori K
        • Slavit DH
        • Kacker A
        • et al.
        Influence of size and etiology of glottal gap in glottic incompetence dysphonia.
        Laryngoscope. 1998; 108: 514-518
        • Teixeira João Paulo
        • et al.
        Vocal acoustic analysis – jitter, shimmer and HNR parameters☆.
        Procedia Technol. 2013; 9: 1112-1122
        • Rostampourgonbaki M
        • Deghanpour N
        • Kiakojouri K
        • et al.
        Acoustic voice measures in benign mass lesions.
        Iranian Rehabilitation J. 2022; 20: 363-368
        • Lathadevi HT
        • Suresh Pundalikappa G
        Objective acoustic analysis and comparison of normal and abnormal voices.
        J Clin Diagnostic Res. 2018; (12.12)
        • Oguz H
        • Tarhan E
        • Korkmaz M
        • et al.
        Acoustic analysis findings in objective laryngopharyngeal reflux patients.
        J Voice. 2007; 21: 203-210