{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T07:19:32Z","timestamp":1777619972171,"version":"3.51.4"},"reference-count":105,"publisher":"SAGE Publications","issue":"7_suppl","license":[{"start":{"date-parts":[[2008,7,1]],"date-time":"2008-07-01T00:00:00Z","timestamp":1214870400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2008,7]]},"abstract":"<jats:p>The 532 nm pulsed KTP (potassium titanyl phosphate) laser and the 585 nm pulsed dye laser (PDL) are photoangiolytic lasers that have been demonstrated to be effective for managing vocal fold dysplasia. The putative mechanism of action is selective photoangiolysis of the sublesional microcirculation. On the basis of this experience, early glottic cancers were treated by selectively targeting the intralesional and sublesional microvasculature. This approach was derived from Folkman's concepts of neoplastic growth resulting from tumor angiogenesis. Staged microlaryngeal treatment was adopted, because it facilitated optimal functional results, and was considered safe, because early glottic cancer rarely metastasizes. Furthermore, intercurrent disease during conventional incremental radiotherapy is typical in treating early glottic cancer. A pilot group of 22 patients with early glottic cancer (13 T1, 9 T2) were treated with a fiber-based angiolytic laser. Eleven of the 22 had unilateral disease and were entirely treated by laser photoangiolysis as a sole modality. Eleven of the 22 had bilateral disease; 5 of the 11 were treated entirely (bilaterally) by laser photoangiolysis, and 6 of the 11 only underwent laser treatment of the less involved vocal fold, with conventional resection being done on the dominant side of the cancer. The initial 8 of the 22 were treated with the PDL, and the latter 14 of the 22 were treated with the pulsed KTP laser. No patient has cancer presently, and none have undergone posttreatment radiotherapy or open surgery. The mean follow-up is 27 months, 13 of the 22 patients have at least 2 years of follow-up, and the first patient was treated just over 5 years ago. Objective measures of vocal function revealed that photoangiolytic treatment of early glottic cancer resulted in significant postoperative improvements despite the fact that half of the patients had bilateral disease. Angiolytic lasers effectively involuted early glottic cancer, with microsurgically directed nonionizing radiation of the dense neoplastic blood supply resulting in complete tumor regression. This approach is conceptually attractive, because it is repeatable, it preserves all conventional cancer treatment options, and it results in excellent vocal function by improving phonatory mucosal wave vibration. Observations from this investigation suggest that this new and novel cancer treatment strategy is effective; however, larger patient cohorts, longer follow-up, and multi-institutional confirmation will be necessary to establish incontrovertible oncological efficacy.<\/jats:p>","DOI":"10.1177\/00034894081170s701","type":"journal-article","created":{"date-parts":[[2017,1,10]],"date-time":"2017-01-10T14:30:50Z","timestamp":1484058650000},"page":"3-24","source":"Crossref","is-referenced-by-count":69,"title":["Photoangiolytic Laser Treatment of Early Glottic Cancer: A New Management Strategy"],"prefix":"10.1177","volume":"117","author":[{"given":"Steven M.","family":"Zeitels","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A.","family":"Burns","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerardo","family":"Lopez-Guerra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Rox","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert E.","family":"Hillman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2008,7,1]]},"reference":[{"key":"bibr1-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199503001-00001"},{"key":"bibr2-00034894081170S701","first-page":"239","volume":"21","author":"Hirano M","year":"1975","journal-title":"Otologia (Fukuoka)"},{"key":"bibr3-00034894081170S701","first-page":"13","volume-title":"Dynamic aspects of speech production","author":"Hirano M","year":"1977"},{"key":"bibr4-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348948509400303"},{"key":"bibr5-00034894081170S701","unstructured":"Batsakis JG. Tumors of the head and neck. Clinical and pathological considerations. Baltimore, Md: Williams & Wilkins, 1982:121\u20139."},{"key":"bibr6-00034894081170S701","unstructured":"Jako GJ, Kleinsasser O. Endolaryngeal micro-diagnosis and microsurgery. Reprint from the Annual Meeting of the American Medical Association, 1966."},{"key":"bibr7-00034894081170S701","first-page":"560","volume":"3","author":"Strong MS","year":"1974","journal-title":"Can J Otolaryngol"},{"key":"bibr8-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348940411300403"},{"key":"bibr9-00034894081170S701","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1177\/000348940711600901","volume":"116","author":"Zeitels SM","year":"2007","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"bibr10-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/019459989110500322"},{"key":"bibr11-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1016\/S1043-1810(10)80193-9"},{"key":"bibr12-00034894081170S701","first-page":"373","volume-title":"Laryngeal cancer: Proceedings of the 2nd World Congress on Laryngeal Cancer","author":"Zeitels SM","year":"1994"},{"key":"bibr13-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(96)00295-4"},{"key":"bibr14-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1126\/science.6836297"},{"key":"bibr15-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.1900010310"},{"key":"bibr16-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.1900030303"},{"key":"bibr17-00034894081170S701","unstructured":"Zeitels SM. Atlas of phonomicrosurgery and other endolaryngeal procedures for benign and malignant disease. San Diego, Calif: Singular, 2001:177\u2013218."},{"key":"bibr18-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348940311200902"},{"key":"bibr19-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348940611500905"},{"key":"bibr20-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1097\/mlg.0b013e31802b5c1c"},{"key":"bibr21-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197111182852108"},{"key":"bibr22-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1006\/rwgn.2001.1545"},{"key":"bibr23-00034894081170S701","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/000348940211100101","volume":"111","author":"Zeitels SM","year":"2002","journal-title":"Ann Otol Rhinol Laryngol Suppl"},{"key":"bibr24-00034894081170S701","volume-title":"A treatise on diseases of the air passages","author":"Green H","year":"1846"},{"key":"bibr25-00034894081170S701","volume-title":"Observations on the pathology of croup","author":"Green H","year":"1849"},{"key":"bibr26-00034894081170S701","first-page":"241","volume":"1","author":"Green H","year":"1854","journal-title":"Am Med Monthly"},{"key":"bibr27-00034894081170S701","first-page":"30","volume":"1","author":"Eisberg L","year":"1879","journal-title":"Trans Am Laryngol Assoc"},{"key":"bibr28-00034894081170S701","unstructured":"Dr Horace Green and his method. Harper's Weekly 1859;February 5:88\u201390."},{"key":"bibr29-00034894081170S701","first-page":"397","volume":"7","author":"Garcia M","year":"1855","journal-title":"Proc R Soc Lond"},{"key":"bibr30-00034894081170S701","unstructured":"Green H. On the surgical treatment of polypi of the larynx, and oedema of the glottis. New York, NY: GP Putnam, 1852:46\u201365."},{"key":"bibr31-00034894081170S701","first-page":"196","volume":"8","author":"Czermak JN","year":"1858","journal-title":"Wien Med Wochenschr"},{"key":"bibr32-00034894081170S701","first-page":"401","volume":"26","author":"Turck L","year":"1858","journal-title":"Z Gesellsch Aerzte Wien"},{"key":"bibr33-00034894081170S701","first-page":"654","volume":"30","author":"Lewin G","year":"1861","journal-title":"Allg Med Cent Zeitung"},{"key":"bibr34-00034894081170S701","volume-title":"The use of the laryngoscope in diseases of the throat with an appendix on rhinoscopy","author":"Mackenzie M","year":"1865"},{"key":"bibr35-00034894081170S701","volume-title":"Laryngoscopal surgery illustrated in the treatment of morbid growths within the larynx","author":"Eisberg L","year":"1866"},{"key":"bibr36-00034894081170S701","doi-asserted-by":"crossref","unstructured":"Solis-Cohen J. Removal of a fibrous polyp from the inferior surface of the right vocal fold with the aid of the laryngoscope. Am J Med Sci 1867;April:404\u20137.","DOI":"10.1097\/00000441-186704000-00010"},{"key":"bibr37-00034894081170S701","first-page":"244","volume":"4","author":"Solis-Cohen J","year":"1869","journal-title":"Med Rec"},{"key":"bibr38-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.2239.1437-d"},{"key":"bibr39-00034894081170S701","volume-title":"Results for operations for cancer of the larynx","author":"Butlin HT","year":"1908"},{"key":"bibr40-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-190408000-00003"},{"key":"bibr41-00034894081170S701","first-page":"343","volume":"17","author":"Gussenbauer C","year":"1874","journal-title":"Arch Klin Chir"},{"key":"bibr42-00034894081170S701","first-page":"60","volume":"14","author":"Solis-Cohen J","year":"1892","journal-title":"Trans Am Laryngol Assoc"},{"key":"bibr43-00034894081170S701","first-page":"114","volume":"15","author":"Solis-Cohen J","year":"1893","journal-title":"Trans Am Laryngol Assoc"},{"key":"bibr44-00034894081170S701","first-page":"1276","volume":"34","author":"Koller K","year":"1884","journal-title":"Wien Med Wochenschr"},{"key":"bibr45-00034894081170S701","first-page":"1334","volume":"45","author":"Jelinek E","year":"1884","journal-title":"Wien Med Wochenschr"},{"key":"bibr46-00034894081170S701","first-page":"283","volume":"12","author":"Fraenkel B","year":"1886","journal-title":"Arch Klin Chir"},{"key":"bibr47-00034894081170S701","first-page":"156","volume":"3","author":"Kirstein A","year":"1895","journal-title":"Arch Laryngol Rhinol"},{"key":"bibr48-00034894081170S701","volume-title":"Autoscopy of the larynx and trachea (direct examination without mirror)","author":"Kirstein A","year":"1897"},{"key":"bibr49-00034894081170S701","first-page":"1","volume":"3","author":"Oertel M","year":"1895","journal-title":"Arch Laryngol Rhinol"},{"key":"bibr50-00034894081170S701","first-page":"844","volume":"45","author":"Killian G","year":"1898","journal-title":"Munch Med Wochenschr"},{"key":"bibr51-00034894081170S701","first-page":"277","volume":"26","author":"Killian G","year":"1912","journal-title":"Arch Laryngol Rhinol"},{"key":"bibr52-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348941502400301"},{"key":"bibr53-00034894081170S701","first-page":"119","volume":"40","author":"Lynch RC","year":"1920","journal-title":"Trans Am Laryngol Assoc"},{"key":"bibr54-00034894081170S701","first-page":"411","volume":"16","author":"New GB","year":"1941","journal-title":"Mayo Clin Proc"},{"key":"bibr55-00034894081170S701","first-page":"639","volume":"64","author":"Priest RE","year":"1960","journal-title":"Trans Am Acad Opthalmol Otolaryngol"},{"key":"bibr56-00034894081170S701","first-page":"146","volume-title":"Workshops from the Centennial Conference on Laryngeal Cancer","author":"DeSanto LW","year":"1976"},{"key":"bibr57-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197508000-00003"},{"key":"bibr58-00034894081170S701","first-page":"265","volume":"1","author":"Jako GJ","year":"1978","journal-title":"Int Adv Surg Oncol"},{"key":"bibr59-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1002\/lary.1978.88.9.1399"},{"key":"bibr60-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(78)90267-2"},{"key":"bibr61-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e3282f1fbb2"},{"key":"bibr62-00034894081170S701","first-page":"132","volume":"30","author":"R\u00f6ntgen WG","year":"1895","journal-title":"Kunsthandlung"},{"key":"bibr63-00034894081170S701","first-page":"175","volume":"127","author":"Curie P","year":"1898","journal-title":"Compt Rend Acad Sci"},{"key":"bibr64-00034894081170S701","volume-title":"X-ray treatment of pharyngeal carcinoma","author":"Voigt","year":"1896"},{"key":"bibr65-00034894081170S701","first-page":"984","volume":"76","author":"Scheppegrell W","year":"1902","journal-title":"N Y Med J"},{"key":"bibr66-00034894081170S701","first-page":"1161","volume":"1","author":"Regaud C","year":"1922","journal-title":"Arch Int Laryngol"},{"key":"bibr67-00034894081170S701","first-page":"251","volume":"97","author":"Stevenson WC","year":"1914","journal-title":"Med Press Circular"},{"key":"bibr68-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1259\/0007-1285-25-294-309"},{"key":"bibr69-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1259\/0007-1285-26-310-525"},{"key":"bibr70-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1259\/0007-1285-25-294-302"},{"key":"bibr71-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.2307\/3572011"},{"key":"bibr72-00034894081170S701","first-page":"357","volume":"4","author":"Ellis F","year":"1965","journal-title":"Curr Top Radiat Res"},{"key":"bibr73-00034894081170S701","first-page":"92","volume":"77","author":"Lillie JC","year":"1973","journal-title":"Trans Am Acad Ophthalmol Otolaryngol"},{"key":"bibr74-00034894081170S701","first-page":"552","volume":"3","author":"DeSanto LW","year":"1974","journal-title":"Can J Otolaryngol"},{"key":"bibr75-00034894081170S701","unstructured":"Burns JA, Kobler JB, Heaton JT, Anderson RR, Zeitels SM. Predicting clinical efficacy of photoangiolytic and cutting\/ablating lasers using the chick chorioallantoic membrane model: Implications for endoscopic voice surgery. Laryngoscope (in press)."},{"key":"bibr76-00034894081170S701","first-page":"1","volume":"108","author":"Zeitels SM","year":"1999","journal-title":"Ann Otol Rhinol Laryngol Suppl"},{"key":"bibr77-00034894081170S701","unstructured":"Zeitels SM. Atlas of phonomicrosurgery and other endolaryngeal procedures for benign and malignant disease. San Diego, Calif: Singular, 2001:23\u201336."},{"key":"bibr78-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348940411300104"},{"key":"bibr79-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348949410300902"},{"key":"bibr80-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1016\/S1043-1810(98)80003-1"},{"key":"bibr81-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200410000-00035"},{"key":"bibr82-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1121\/1.396829"},{"key":"bibr83-00034894081170S701","volume-title":"Human larynx coronal section atlas","author":"Tucker GF","year":"1971"},{"key":"bibr84-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/019459988809800205"},{"key":"bibr85-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512283332608"},{"key":"bibr86-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348948909800901"},{"key":"bibr87-00034894081170S701","first-page":"25","volume-title":"Phonosurgery","author":"Bouchayer M","year":"1991"},{"key":"bibr88-00034894081170S701","first-page":"25","volume-title":"Phonosurgery","author":"Hirano M","year":"1991"},{"key":"bibr89-00034894081170S701","volume-title":"Atlas of phonomicrosurgery and other endolaryngeal procedures for benign and malignant disease","author":"Zeitels SM","year":"2001"},{"key":"bibr90-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200401000-00033"},{"key":"bibr91-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2005.10.001"},{"key":"bibr92-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348940611500708"},{"key":"bibr93-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348940010900409"},{"key":"bibr94-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1007\/BF00879268"},{"key":"bibr95-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200110000-00036"},{"key":"bibr96-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1007\/s004050100350"},{"key":"bibr97-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348940711600901"},{"key":"bibr98-00034894081170S701","first-page":"342","volume":"52","author":"Broyles EN","year":"1943","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"bibr99-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348949210100202"},{"key":"bibr100-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1016\/0196-0709(93)90050-H"},{"key":"bibr101-00034894081170S701","first-page":"174","volume":"38","author":"Thumfart WF","year":"1990","journal-title":"HNO"},{"key":"bibr102-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra035148"},{"key":"bibr103-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2004.02.001"},{"key":"bibr104-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1016\/S1043-1810(98)80007-9"},{"key":"bibr105-00034894081170S701","doi-asserted-by":"publisher","DOI":"10.1177\/000348940311200213"}],"container-title":["Annals of Otology, Rhinology &amp; Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00034894081170S701","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00034894081170S701","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:18:31Z","timestamp":1777375111000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00034894081170S701"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,7]]},"references-count":105,"journal-issue":{"issue":"7_suppl","published-print":{"date-parts":[[2008,7]]}},"alternative-id":["10.1177\/00034894081170S701"],"URL":"https:\/\/doi.org\/10.1177\/00034894081170s701","relation":{},"ISSN":["0003-4894","1943-572X"],"issn-type":[{"value":"0003-4894","type":"print"},{"value":"1943-572X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,7]]}}}