Un-sedated office-based Thulium laser therapy in patients with Reinke’s edema
Channel: Anthony Ghanem
Date: 15/05/2020

Abdul-Latif Hamdan1, MD,EMBA,MPH, FACS; Anthony Ghanem1, MD; Pierre Richard Abi Akl1, MD, Aya El Hage1, MPH.
1Department of Otolaryngology – Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.

Objective

To report the outcome of un-sedated office based Thulium laser therapy for Reinke’s edema. 

Materials and Methods

A retrospective chart review of patients operated between March 2017 and November 2018 was conducted. Twelve patients were included, two of whom had two procedures performed. Demographic data included age, gender, smoking status and grade of Reinke’s edema. Outcome measures included Voice Handicap Index-10, perceptual evaluation, extent of disease regression, acoustic analysis, and maximal phonation time.

Results

Twelve patients were enrolled in this study, one of whom was lost for follow-up. There were 8 females and three males The mean age was 51.27 +/- 9.12 years. Endoscopic evaluation 6-12 weeks after surgery revealed complete and partial regression of disease in 3 and 8 patients respectively. There was a significant improvement in the mean score of VHI-10 (15.00 +/- 9.45 vs. 3.07 +/- 3.81) and the mean score of GRABS parameters following surgery (p less than0.05). The mean habitual pitch (HP) increased from 125.11 +/- 28.48 Hz to 155.86 +/- 55.14 Hz (p = 0.070). There was improvement in the mean jitter and shimmer but none reached a statistical significance. There was no significant change in the mean MPT scores before and after surgery. 

Conclusion

Un-sedated office-based Thulium laser therapy can be considered as an alternative therapy to patients with Reinke’s edema who are not willing to undergo conventional microlaryngeal surgery.