Office-Based Laser Therapy for Vocal Fold Cyst: A Promising Alternative Therapy Using the 445 nm Blue Laser

Vocal fold cysts are benign lesions commonly encountered in laryngology practice. They are traditionally classified as mucus retention cysts and epidermoid cysts. The mainstay treatment is surgical excision with diligent dissection of the cyst wall. The authors of this manuscript report a series of two cases of vocal fold mucous retention cysts and one case of vocal fold pseudocyst treated with the blue laser (Wolf TruBlue 445 nm; A.R.C. Laser Company) in an office setting. All three cases had complete regression of the lesion with improved glottic closure and mucosal waves during phonation. The disease regression was associated with a decrease in the VHI-10 score, perceptual voice evaluation scores, and acoustic perturbation parameters. There was also an increase in maximum phonation time in all three cases. The authors advocate office-based blue laser therapy for vocal fold cysts as a promising treatment modality, particularly in patients at high risk for general anesthesia. Nevertheless, the possible increased risk of vocal fold scarring given the lack of binocular microscopic examination should not be underestimated. A larger study is needed to cast more information on the surgical outcome and long-term effects of blue laser therapy in the management of vocal fold cysts.