Objective: To investigate the effectiveness of a single office-based blue laser therapy (OBLT) session for vocal fold dysplasia, and to analyze the correlation between disease regression and grade of the lesion.
Methodology: The medical records and video-recordings of all patients with vocal fold dysplasia who underwent OBLT between December 2022 and September 2024 were reviewed. Lesions were classified as low-grade and high-grade dysplasia. Outcome measures included the Voice Handicap Index-10 (VHI-10) score, acoustic parameters, maximum phonation time (MPT), and disease regression as seen on laryngeal examination.
Results: A total of 15 patients with 22 vocal fold dysplasia, 7 low-grade and 15 high-grade, were included in this study. The mean VHI-10 score of the study group decreased significantly from 14.73 ± 10.40 pre-operatively to 3.20 ± 7.85 post-operatively (p<0.001). There was also a statistically significant decrease in jitter percent from 1.47 ± 1.13 to 0.80 ± 0.49 (p=0.006), and in shimmer percent from 5.31 ± 4.59 to 2.70 ± 1.38 post-operatively (p=0.012). Out of the 22 lesions treated, 14 regressed completely (63.6%) and 8 regressed partially (36.4%) following a single laser session. Low-grade dysplastic lesions were 10 times more likely to regress completely following treatment compared to high-grade lesions (OR=10.00; 95%CI =1.26–79.34). All patients with partial disease regression (n=5) underwent a second office-based blue laser therapy except for one who was lost for follow-up. Out of these 7 lesions, 5 regressed completely (71.4%) and 2 lesions regressed partially (28.6%).
Conclusion: A single office-based blue laser therapy session may be an effective treatment modality for vocal fold dysplasia resulting in complete or partial disease regression. A higher response noted was noted in low-grade dysplastic lesions compared to high-grade lesions. Patient counseling regarding the need for a second laser treatment session in the case of high-grade dysplasia is therefore recommended.