Sonam Dodhia1, Peter C Baxter2, Fei Ye3, Michael J Pitman1. 1. Department of Otolaryngology-Head and Neck Surgery, The Voice and Swallowing Institute, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York. 2. Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente, Los Angeles, California, U.S.A. 3. Department of Pathology, Mount Sinai Health System, New York, New York.
Abstract
OBJECTIVES: Recurrent respiratory papillomatosis is often treated with in-office laser procedures using a potassium titanyl phosphate (KTP) laser transmitted through a laser fiber. Although effective, this procedure has notable downsides, including the possibility of transmitting human papillomavirus (HPV) in the smoke plume and the high cost of these single-use fibers. The objective of this study is to determine if HPV can be detected on a laser fiber after use, with or without sterilization. METHODS: Twelve patients with laryngeal papillomas were treated with KTP laser energy transmitted via a KTP fiber. Ten fibers were sterilized in CIDEX (ASP, Irvine, California), a glutaraldehyde disinfectant, for 12 minutes, whereas two fibers were left unsterilized. Human papillomavirus DNA amplification was done on all 12 fiber samples with real-time polymerase chain reaction (PCR) using general primer mediated 5+ and 6+. Human papillomavirus genotyping detection was done using type specific probes and/or Sanger sequencing. RESULTS: Over 27 strains of HPV were not detected on KTP fibers after use, with or without sterilization. CONCLUSION: Human papillomavirus was undetectable by PCR on KTP laser fibers that were sterilized or unsterilized after use. Further studies are needed utilizing a transmission model to determine if HPV can be incubated from this fiber after sterilization. LEVEL OF EVIDENCE: NA. Laryngoscope, 128:926-928, 2018.
OBJECTIVES: Recurrent respiratory papillomatosis is often treated with in-office laser procedures using a potassium titanyl phosphate (KTP) laser transmitted through a laser fiber. Although effective, this procedure has notable downsides, including the possibility of transmitting human papillomavirus (HPV) in the smoke plume and the high cost of these single-use fibers. The objective of this study is to determine if HPV can be detected on a laser fiber after use, with or without sterilization. METHODS: Twelve patients with laryngeal papillomas were treated with KTP laser energy transmitted via a KTP fiber. Ten fibers were sterilized in CIDEX (ASP, Irvine, California), a glutaraldehyde disinfectant, for 12 minutes, whereas two fibers were left unsterilized. Human papillomavirus DNA amplification was done on all 12 fiber samples with real-time polymerase chain reaction (PCR) using general primer mediated 5+ and 6+. Human papillomavirus genotyping detection was done using type specific probes and/or Sanger sequencing. RESULTS: Over 27 strains of HPV were not detected on KTP fibers after use, with or without sterilization. CONCLUSION:Human papillomavirus was undetectable by PCR on KTP laser fibers that were sterilized or unsterilized after use. Further studies are needed utilizing a transmission model to determine if HPV can be incubated from this fiber after sterilization. LEVEL OF EVIDENCE: NA. Laryngoscope, 128:926-928, 2018.
Authors: Nicola Pavan; Alessandro Crestani; Alberto Abrate; Cosimo De Nunzio; Francesco Esperto; Gianluca Giannarini; Antonio Galfano; Andrea Gregori; Giovanni Liguori; Riccardo Bartoletti; Francesco Porpiglia; Alchiede Simonato; Carlo Trombetta; Andrea Tubaro; Vincenzo Ficarra; Giacomo Novara Journal: Eur Urol Focus Date: 2020-06-05