Serial in-office laser treatment of vocal fold leukoplakia: Disease control and voice outcomes

Shira L. Koss, Peter Baxter, Haig Panossian, Peak Woo, Michael J. Pitman

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Objective: Although vocal fold (VF) leukoplakia is commonly treated with in-office laser, there is no data on its long-term effectiveness. This study hypothesizes that VF leukoplakia treated by serial in-office laser results in long-term disease control with maintenance of voice and minimal morbidity. Study Design: Retrospective review (2008–2015). Methods: Forty-six patients with VF leukoplakia treated by in-office KTP (potassium titanyl phosphate) or PDL (pulsed dye laser) were included. Median follow-up from final laser treatment was 19.6 months. Main outcomes included: 1) rate of disease control, 2) percentage of disease regression using ImageJ analysis. Secondary outcomes included vocal assessment using the Voice Handicap Index-10 (VHI-10). Results: Patients underwent a median of 2 (range: 1–6) in-office laser treatments. Time between treatments was median 7.6 months. After final treatment, 19 patients (41.3%) had no disease; two patients (4.3%) progressed to invasive cancer; overall disease regression was median 77.1% (P < 0.001); and VHI-10 score decreased by median 5 (P = 0.037). Thirty-one patients (67.4%) were responders (controlled with in-office treatment only); failures were 13 patients (28.3%) who required operative intervention and two patients (4%) who underwent radiation. Compared to responders, failures demonstrated significantly shorter duration between treatments (median 2.3 vs. 8.9 months, P = 0.038) and significantly less regression (median 49.3% vs. 100%, P = 0.006). Conclusion: Serial outpatient KTP or PDL treatment of VF leukoplakia is effective for disease control with minimal morbidity and preservation of voice quality. We suggest that patients requiring repeated in-office treatment every 6 months may benefit from earlier operative intervention; other factors associated with in-office success remain unclear. Level of Evidence: 4. Laryngoscope, 127:1644–1651, 2017.

Original languageEnglish
Pages (from-to)1644-1651
Number of pages8
Issue number7
StatePublished - Jul 2017


  • KTP
  • in-office laser
  • vocal fold leukoplakia


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