For the patient, the procedure offers an office-based outpatient procedure that requires very little aftercare. The only recommendation by Dr. Woo is that patients rest their voices for three to four days following each treatment.
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May 2008Further Evidence Needed
For Dr. Koufman, who, along with Dr. Woo, helped pioneer the use of the pulsed-dye laser to treat vocal fold scars, more data are needed to prove the applicability of the procedure beyond its current predominantly theoretical status.
Even with more data, however, she thinks that the procedure may only be useful for certain types of scarring. There will be no one-size-fits-all [treatment] even for vocal fold scarring, she said. There are too many variables. Sometimes you have soft tissue deficiency, so softening up won’t be enough. It makes a big difference if the scarring is one-sided or bilateral or if it is predominantly localized or involves the whole vocal fold. Postoperative scarring is also probably different than phonotrauma.
If the technique is used, Dr. Koufman thinks it most likely will be used for adynamic segments and for sulcus vocalis-a congenital or acquired condition in which there is a loss of the superficial lamina propria that runs along the edge of the vocal fold that makes contact during vocal fold vibration.
Whenever we have a new technology it looks great in the beginning, and then it finds its place in the surgical armamentarium with great specificity, she said.
For Dr. Woo, the response he is getting from his patients makes it worthwhile to pursue this treatment option. We’re pretty excited about this because we haven’t had anything to offer our patients before this, he said, adding that he has received many comments from his patients, many of whom have expressed quite dramatic and heartfelt responses to this treatment.
News & Notes
Sex, Drugs, and Cancer?
Some head and neck cancers have been linked to sexual activity and marijuana use, while others have been tied to tobacco and alcohol use, and poor oral hygiene, according to a study published in the March 11 online edition of the Journal of the National Cancer Institute.
Researchers from Johns Hopkins University, led by Maura L. Gillison, MD, PhD, conducted a hospital-based case-control study to compare the risk factor profiles for human papillomavirus (HPV)-16-positive and HPV-16-negative head and neck squamous cell carcinomas (HNSCCs). The study involved 240 individuals with HNSCC and 322 individuals without cancer, who were matched by age and sex to each HPV-16-positive and HPV-16-negative individual. All individuals were surveyed on risk behaviors via computer-assisted self-interview technology.