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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentations 2 - Laryngology/Broncho-Esophagology

Proposed Classification System and Settings for the Use of Blue Light Laser for Laryngeal Lesions

Sunday, September 29, 2024
9:54 AM – 10:00 AM EDT
Location: MBCC, 224
Disclosure(s):
Mahnoor S. Khan, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Yassmeen Abdel-Aty, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

David E. Rosow, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Pavan S. Mallur, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Michael M. Johns III, MD, III:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Clark A. Rosen, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Only preliminary investigations on the use of the 445 nm wavelength blue light laser for various laryngeal pathologies have been described. While the laser may be utilized variably for photoangiolytic, ablative, and cutting effects, currently no standard exists for reporting treatment technique with this modality. Here, we aim to establish a protocol for laser settings specific to lesion characteristics and to validate a classification schema for reporting immediate tissue effects with laser treatment.

Methods: Video recordings from operating room and in-office awake laryngeal procedures performed with the blue light laser were retrospectively obtained. Prospective video recordings determined tissue effects were also collected. Video recordings were reviewed by five academic laryngologists and annotated for perceived tissue effect. A 5-point classification was developed based on expert consensus. Procedure clips were rated utilizing the classification schema for perceived tissue effect and the classification system validated with inter- and intra-rater reliability measures. Laser settings were correlated with tissue effect for prospective cases.

Results: A total of 10 retrospective and 10 prospective cases were reviewed. The classification system included angiolysis, epithelial blanching, non-contact tissue melting, contact tissue melting, ablation with tissue removal, and charring. Raters reached high inter- and intrareliability when classifying tissue effects based on the proposed classification. A guide for recommended settings based on tissue effect, method of delivery (awake-trans nasal/asleep-direct laryngoscopy), and pathology was developed for each class of tissue effect.

Conclusions: Blue light laser use can be standardized with this validated classification system of immediate laser effect and lesion-specific laser settings, facilitating future systematic study of outcomes and effective communication between laryngologists.

    Presenting Author(s)

  • Mahnoor S. Khan, MD

    Resident
    Department of Otolaryngology- Head & Neck Surgery, University of South Florida Morsani College of Medicine
    Tampa, FL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Yassmeen Abdel-Aty, MD

    Assistant Professor
    Department of Otolaryngology- Head & Neck Surgery, Division of Laryngology, University of South Florida Morsani College of Medicine
    TAMPA, FL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • David E. Rosow, MD

    Professor of Otolaryngology, Division of Laryngology
    University of Miami Health System
    Miami, FL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • PM

    Pavan S. Mallur, MD

    Assistant Professor
    Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School
    Boston, MA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Michael M. Johns, III, MD

    Professor
    Caruso Department of Otolaryngology – Head and Neck Surgery, Keck School of Medicine, University of Southern California
    Los Angeles, California, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Clark A. Rosen, MD

    Professor
    UCSF Voice & Swallowing Center
    San Francisco, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Yael Bensoussan, MD

    Assistant Professor
    Department of Otolaryngology – Head & Neck Surgery, University of South Florida, Tampa, Florida, USA
    Tampa, Florida, United States

    Disclosure information not submitted.