PHILADELPHIA, Pa. (KFSN) -- Tom Mullen is a retired hospital nurse, who spent his life taking care of his patients. It was during that time that he became very hoarse and barely able to speak. "It would just be a gradual decrease in the volume in my voice, almost to a whisper," explained Mullen.
Tom, who smoked for years, feared the worst. Using a camera inserted into his throat, a specialist found extensive lesions on Tom's vocal cords. Prompting the doctor to recommend something called KTP laser treatment.
Ahmed M. S. Soliman, MD, Professor & Interim Chair as well as Director, Voice, Airway, & Swallowing Center, Department of Otolaryngology, Head & Neck Surgery of Lewis Katz School of Medicine at Temple University explained, "Tumors, as we know, and precancerous lesions as well, as tom had, have a very robust blood supply. And so the laser pretty much focuses in on those blood vessels and chokes off the blood supply."
The KTP's pulsating light is an intermittent beam, which allows treated tissues to cool down, and that minimizes scarring.
Dr. Soliman commented, "He's done great. You know it required two surgeries and then a final touchup again because of how diffused his disease was. So you know we did the first surgery, he recovered for a few weeks and then about a month later we took back and removed the rest."
"When you start to lose your voice, seek out this help immediately, because if they catch this early, it can be rectified," said Mullen.
KTP laser surgery is performed under general anesthesia, but has a rapid healing time and is much less invasive than traditional cutting with a scalpel or using radiation.
Contributors to this news report include: Donna Parker, Field Producer; Kirk Manson, Videographer; Cyndy McGrath, Supervising Producer; Gabriella Battistiol, Assistant Producer; Roque Correa, Editor.
BACKGROUND: Dysplasia or pre-cancer of the vocal cords can present as white or red patches on one or both of the vocal cords, and may result in hoarseness. Vocal cord carcinoma-in-situ can be considered very severe dysplasia and essentially represents the last step of the process before transitioning into vocal cord cancer. Another term associated with this change of the vocal cords includes keratosis or a skin-like thickening of the surface. The majority of patients with dysplasia were at one point smokers, even though it may have been many years prior to developing vocal cord dysplasia.
DIAGNOSING: Suspicious legions are noted during a stroboscopy which is a special method of examination using a bright flashing light that lasts a fraction of a second to illuminate the vocal folds; this flash 'freezes' the movement of the vibrating vocal folds. The only way to diagnose dysplasia is by performing a biopsy on a portion of the entire vocal fold, as a doctor cannot diagnose dysplasia by looking at the vocal cord alone. The goal of treatment is to prevent cancer while maintaining an excellent voice, which can be a challenging task. Removing all of the abnormal tissue means not only can the lesion reoccur fairly easily, but the patient may be left with a hoarse voice.
(Sources: https://throatdisorder.com/voice-disorders/vocal-cord-dysplasia/, https://cvtresearch.com/understanding-laryngeal-stroboscopy/)
TREATMENT: Potassium Titanyl Phosphate or KTP Laser is a treatment option that allows patients a chance to treat dysplasia of the vocal cords before it transforms into cancer. The end goal is to remove the diseased membranes while preserving or restoring the voice. The patient is scheduled to go under general anesthesia in the operating room and have the larynx examined with a surgical microscope. This minimally-invasive operation is performed though the mouth, and during this procedure the dysplasia is typically biopsied and treated using the pulsed-potassium-titanyl-phosphate (KTP) laser. The pulsing light is an intermittent beam that allows treated tissues to cool down which minimizes scarring. It is much less invasive than traditional cutting with a scalpel or using radiation. The patient usually leaves the hospital later that day, several hours after the procedure.
Ahmed Soliman, MD)
MORE FROM DR. SOLIMAN: Using a special camera attached to a telescope placed through his mouth in the office, a specialist found the extensive lesions on Tom's vocal cords, prompting the doctor to recommend a biopsy which confirmed precancerous changes. He was then offered removal of the lesions using the KTP laser. The KTP laser used in pulsating mode provides an intermittent beam, which allows treated tissues to cool down in between pulses, and thus minimizes thermal injury and subsequent scarring.
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