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The Use of the Pulse Dye Laser: Treatment of Sulcus Vocalis

Objective: Based on the similarity between the histopathology of sulcus vocalis and scar tissue, and numerous reports on pulse dye laser (PDL) regarding laryngeal lesions, especially the scar tissue, the authors evaluated the efficacy of treating sulcus vocalis with PDL and named this surgical procedure “PDL glottoplasty.” Methods: This study was conducted on 25 patients diagnosed with sulcus vocalis on video-stroboscopy at Gangnam Severance Hospital from August 2006 to February 2012. The delivery energy was fixed at 0.74J per pulse, and all procedures were performed under general anesthesia, exposing the larynx with suspension laryngoscope and observing the lesion with microscope. Aerodynamic, stroboscopic, and acoustic voice analyses were performed pre- and postoperatively, and electroglottographic analysis was conducted for voice analysis on sentence domain. Results: The vocal folds generally showed alleviated vocal fold stiffness and mucosal wave, resulting in improved vocal fold vibration and dysphonia. And most PDL glottoplasty patients showed definite improvement in post-treatment voice analysis indices. The differences between pre- and postoperative voice parameter were statistically significant. Conclusion: PDL glottoplasty seems to be beneficial to the treatment of sulcus vocalis. Considering that the results of other various elaborate techniques have been disappointing and even induced secondary scar formation, resulting vocal fold stiffness, our study of PDL glottoplasty using the characteristic photoangiolysis of the sublesional microcirculation of the PDL offers favorable alternative to the treatment of sulcus vocalis.