Aminolevulinic acid 585 nm pulsed dye laser photodynamic treatment of laryngeal keratosis with atypia

Abstract

Objective To evaluate the safety and efficacy of aminolevulinic acid photodynamic therapy (ALA-PDT) with the 585 nmpulsed dye laser. Methods A 5-year prospective study was performed with 12 male patients with keratosis. Twenty percent ALA was sprayed into the larynx and activated with the 585 nm pulsed dye laser (PDL). Of the 12 patients, four were not included (one lost to follow-up, two developed cancer, one papillomatosis), which reduced the number to eight. Twenty-eight procedures were performed in these eight patients; 18 (64%) procedures were performed in the clinic setting. Results There was a 78% reduction (range, 10% to 100%) in the keratosis. No major side effects were noted. Mean follow-up was 34.5 months (range, 12 to 50 months). There were no statistical differences between the outpatient and operating room treatments. Conclusions ALA-PDL PDT is effective and safe in treating laryngeal keratosis in the awake clinic setting and reduces morbidity without sacrificing treatment efficacy.