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Review
. 2011 Jun;8(2):75-85.
doi: 10.1016/j.pdpdt.2011.01.001.

Photodynamic therapy in the management of pre-malignant head and neck mucosal dysplasia and microinvasive carcinoma

Harry Quon  1 , Craig E Grossman, Jarod C Finlay, Timothy C Zhu, Clarice S Clemmens, Kelly M Malloy, Theresa M Busch
Affiliations
Review

Photodynamic therapy in the management of pre-malignant head and neck mucosal dysplasia and microinvasive carcinoma

Harry Quon et al. Photodiagnosis Photodyn Ther. 2011 Jun.

Abstract

The management of head and neck mucosal dysplasia and microinvasive carcinoma is an appealing strategy to prevent the development of invasive carcinomas. While surgery remains the standard of care, photodynamic therapy (PDT) offers several advantages including the ability to provide superficial yet wide field mucosal ablative treatment. This is particularly attractive where defining the extent of the dysplasia can be difficult. PDT can also retreat the mucosa without any cumulative fibrotic complications affecting function. To date, clinical experience suggests that this treatment approach can be effective in obtaining a complete response for the treated lesion but long term follow-up is limited. Further research efforts are needed to define not only the risk of malignant transformation with PDT but also to develop site specific treatment recommendations that include the fluence, fluence rate and light delivery technique.

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Conflict of interest statement

Conflict of Interests: None

Figures

Figure 1
Figure 1. The Placement of a Balloon Diffuser with a Radial Diffusing Light Source for the Treatment of Glottic Dysplasia
Figure 1A demonstrates the placement of the balloon diffuser with adjacent fibers measuring the fluence rate. The balloon was carefully inflated taking care to gently compress the adjacent glottic without distorting the mucosa and its potential vasculature (1B).
Figure 2
Figure 2. The Placement of a Balloon Diffuser with a Radial Diffusing Light Source for the Treatment of Extensive Oral Tongue Dysplasia
Biopsy proven severe dysplasia is seen in the anterior (A) and the posterior lateral and ventral left oral tongue that extends to the floor of mouth. Figure 2C demonstrates a longitudinal balloon diffuser inflated and placed in the floor of mouth with the lateral tongue mucosa rolled in contact with the balloon surface.
Figure 3
Figure 3. Transoral Robotic Surgery Photodynamic Therapy (TORS-PDT)
Figure 3A demonstrates the intraoperative arrangement of the robotic arms holding the laser light source and a fiber measuring the fluence rate along with a light filter cap placed over the robotic camera (3B).
Figure 3
Figure 3. Transoral Robotic Surgery Photodynamic Therapy (TORS-PDT)
Figure 3A demonstrates the intraoperative arrangement of the robotic arms holding the laser light source and a fiber measuring the fluence rate along with a light filter cap placed over the robotic camera (3B).
See this image and copyright information in PMC

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