Laryngotracheal Stenosis as a Complication of Photodynamic Therapy

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.

目的：光动力疗法（PDT）已被提议作为黏膜癌（如早期喉鳞状细胞癌）的一种有效治疗方法。它相对于其他传统治疗方式（手术和放化疗）的优势在于其在治疗疾病的同时能够保留喉部的功能和结构。虽然在美国未获食品药品监督管理局（FDA）批准，但在一些国家它被用作喉癌的一种治疗方法，并且是一个积极研究的领域。本报告记录了一例因PDT导致的依赖气管切开的喉气管狭窄这一严重并发症。 方法：方法包括病例报告和文献综述。 结果：一名65岁男性在PDT成功治疗其喉癌后，出现了声门上、声门及声门下喉部的严重狭窄。详细介绍了他的症状、分期气道重建情况以及治疗结果。 结论：PDT是一种微创技术，在早期临床试验中，其治疗早期头颈部鳞状细胞癌的有效性与传统疗法相当。它使用一种被肿瘤细胞摄取的光敏剂，从而能够选择性地破坏肿瘤细胞。治疗后的永久性后遗症鲜有报道；最常见的不良反应包括疼痛、声音嘶哑和光毒性。然而，我们的病例报告探讨了PDT后可能出现需要进行气道重建的严重喉气管狭窄情况。