Comparative Effectiveness of Office-Based 532-nm Laser-Assisted Vocal Polypectomy and Phonomicrosurgery: A Matched Cohort Study

Abstract

Objectives:

Office-based procedures, including indirect laryngoscopic surgery and angiolytic laser photocoagulation, have been proposed to treat hemorrhagic vocal polyps. Our previous research documented good treatment outcomes by combining the 2 aforementioned procedures (laser-assisted vocal polypectomy [LAVP]). This study intends to further compare the effectiveness of LAVP with the gold standard of phonomicrosurgery.

Methods:

This study retrospectively enrolled 50 age-, sex-, and size-matched patients of hemorrhagic vocal polyps treated by LAVP or phonomicrosurgery at a tertiary teaching hospital from January 2012 to October 2013. Treatment outcomes were evaluated before, 2 weeks after, and 6 weeks after the procedures via perceptual rating of voice quality, acoustic measurement of the speech signal, 10-item voice-handicap index (VHI-10), maximal phonation time (MPT), subjective rating of voice quality, and videolaryngostroboscopic evaluations.

Results:

Both LAVP and phonomicrosurgery demonstrated significant improvements in most measuring parameters, 2 and 6 weeks postoperatively. Comparative effectiveness demonstrated similar objective outcomes (MPT, VHI-10, perceptual, endoscopic, and acoustic analyses) between LAVP and phonomicrosurgery, while patients who received LAVP reported more symptomatic relief and higher subjective voice quality then phonomicrosurgery 2 weeks postoperatively. Six weeks after the procedures, both objective and subjective effectiveness revealed non-significant differences between the 2 treatment groups.

Conclusions:

This study demonstrated that office-based 532-nm LAVP can be an effective, practical, and safe alternative treatment for small hemorrhagic vocal polyps. Patients who received LAVP experienced rapid symptomatic relief with higher subjective effectiveness than phonomicrosurgery, 2 weeks postoperatively. The overall treatment outcomes showed comparable effectiveness between LAVP and phonomicrosurgery.