Laryngotracheal stenosis as a complication of photodynamic therapy

Ann Otol Rhinol Laryngol. 2015 Jun;124(6):495-8. doi: 10.1177/0003489415570930. Epub 2015 Feb 9.

Abstract

Objective: Photodynamic therapy (PDT) has been proposed as an effective treatment for mucosal carcinomas such as early-stage laryngeal squamous cell carcinoma. Its advantage over other conventional modalities (surgery and chemoradiation) lies in its ability to treat disease while preserving the function and structure of the larynx. While not FDA-approved in the United States, it is used in some countries as a treatment for laryngeal cancer and is an area of active investigation. This report documents a severe complication of tracheostomy-dependent laryngotracheal stenosis resulting from PDT.

Methods: Methods include a case report and review of the literature.

Results: A 65-year-old male presented with severe stenosis of the supraglottic, glottic, and subglottic larynx following successful treatment of his laryngeal carcinoma with PDT. His presentation, staged airway reconstruction, and outcome are detailed.

Conclusion: PDT is a minimally invasive technique which in early clinical trials has matched the effectiveness of conventional therapies for treating early head and neck squamous cell cancers. It uses a photosensitizing agent that is retained by tumor cells, allowing for the selective destruction of neoplastic cells. Permanent sequelae following treatment have rarely been reported; the most commonly described adverse effects include pain, hoarseness, and phototoxicity. However, our case report discusses the potential for significant laryngotracheal stenosis requiring airway reconstruction following PDT.

Keywords: cancer; laryngeal; laryngotracheal; photodynamic; photosensitizer; stenosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / pathology
  • Humans
  • Laryngeal Neoplasms / drug therapy*
  • Laryngeal Neoplasms / pathology
  • Laryngoscopy
  • Laryngostenosis / diagnosis
  • Laryngostenosis / etiology*
  • Laryngostenosis / surgery
  • Male
  • Photochemotherapy / adverse effects*
  • Photosensitizing Agents / adverse effects*
  • Plastic Surgery Procedures / methods
  • Tomography, X-Ray Computed
  • Tracheal Stenosis / diagnosis
  • Tracheal Stenosis / etiology*
  • Tracheal Stenosis / surgery

Substances

  • Photosensitizing Agents