Narrow band imaging-guided microscopic CO2 laser surgery versus conventional microscopic CO2 laser surgery in treatment of vocal cord atypical hyperplasia
- VernacularTitle:窄带成像技术引导下显微CO2激光手术与常规显微CO2激光手术在声带不典型增生治疗中的应用比较
- Author:
Ning MA
1
;
Jia LIANG
;
Qiongfang WU
;
Shejiang ZHANG
Author Information
- Keywords: narrow band imaging; microscopic CO2 laser surgery; vocal cord atypical hyper-plasia; margin accuracy; inflammatory factors; complications; laryngoscope; voice-related parameters
- From: Journal of Clinical Medicine in Practice 2025;29(14):104-107,114
- CountryChina
- Language:Chinese
- Abstract: Objective To compare the clinical efficacy of narrow band imaging(NBI)-guided microscopic CO2 laser surgery and conventional microscopic CO2 laser surgery in treatment of patients with vocal cord atypical hyperplasia.Methods A total of 90 patients with vocal cord atypical hyper-plasia were enrolled as study subjects.Based on different surgical approaches,they were divided into conventional group(43 cases,undergoing conventional microscopic CO2 laser surgery)and NBI-guided group(47 cases,undergoing NBI-guided microscopic CO2 laser surgery).The negative mar-gin rate,complication rate,recurrence rate,and the levels of voice-related parameters(jitter,shim-mer,noise-to-harmonic ratio)and inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)]before and after surgery were compared between the two groups.Results The negative mar-gin rate of the first-time biopsy after laser surgery in the NBI-guided group was 97.87％,which was higher than 86.05％in the conventional group,with a statistically significant difference(P＜0.05).After surgery,the jitter,shimmer and noise-to-harmonic ratio in both groups were lower than those before surgery,with statistically significant differences(P＜0.05),but there was no statistically sig-nificant difference between the two groups(P＞0.05).After surgery,the levels of CRP and IL-6 in both groups were lower than those before surgery,with statistically significant differences(P＜0.05),but there was no statistically significant difference between the two groups(P＞0.05).The compli-cation rate was 4.26％in the NBI-guided group,and 9.30％in the conventional group,with no statistically significant between-group difference(P＞0.05).During a follow-up of 6 months to 2 years,the recurrence rate in the NBI-guided group was 2.13％and 6.98％in the conventional group,with no statistically significant between-group difference(P＞0.05).Conclusion Com-pared with conventional microscopic CO2 laser surgery,NBI-guided microscopic CO2 laser surgery can more precisely determine the range of the lesion and the surrounding mucosal margins and re-duce the number of intraoperative biopsies in the treatment of vocal cord atypical hyperplasia.How-ever,the two surgical methods have similar impacts on postoperative voice-related parameters,in-flammatory factors,complications and recurrence rates.
