Photoangiolytic Lasers for Treatment of Benign Laryngeal Lesions: A Systematic Review and Meta-Analysis

Abstract

Objectives: To compare the efficacy of the 445-nm blue laser to the 585-nm pulsed dye laser (PDL) and 532-nm potassium-titanyl-phosphate (KTP) laser in the treatment of benign laryngeal lesions. Data Sources: Cochrane Library, PubMed, Scopus, and CINAHL. Review Methods: Following PRISMA guidelines, databases were searched from inception through January 29, 2024, for studies reporting the use of photoangiolytic lasers for treatment of benign laryngeal lesions, including the 585-nm PDL, 532-nm KTP laser, and 445-nm blue laser. Outcome measures included lesion resolution (%), mean differences (Δ) in Voice Handicap Index (VHI-10), and summed dysphonia grade, roughness, and breathiness (GRB) scale. Results: A total of 45 studies were included for meta-analysis, consisting of 348 patients treated with PDL, 550 patients with KTP laser, and 338 patients with blue laser. Treatment with blue laser resulted in the greatest lesion resolution (94.0%; 95% confidence interval [CI]: 90.2%–96.7%), followed by KTP laser (90.4%; 95% CI: 84.1%–95.2%), and PDL (86.9%; 95% CI: 62.9%–99.2%). VHI-10 improved significantly in patients following treatment with blue laser (Δ13.3; 95% CI: 10.7–16.0; p < 0.0001), KTP laser (Δ10.3; 95% CI: 7.4–13.3; p < 0.0001), and PDL (Δ7.4; 95% CI: 4.8–10.1; p < 0.0001). GRB improved significantly in patients following treatment with blue laser (Δ4.1; 95% CI: 2.9–5.2; p < 0.0001), KTP laser (Δ3.0; 95% CI: 2.0–4.0; p < 0.0001), and PDL (Δ2.5; 95% CI: 0.8–4.2; p = 0.005). Conclusions: Photoangiolytic lasers are effective in treating benign laryngeal lesions. Blue lasers are promising for laryngeal laser surgery. Laryngoscope, 134:4847–4857, 2024.