Patients treated include Aerosmith's Steven Tyler, who
has returned to performing
A new type of laser for voice surgery (phonosurgery),
utilized for the first time at Massachusetts General Hospital (MGH),
has allowed Aerosmith singer Steven Tyler to resume performing after
a tour-ending vocal injury. Recently, he and Aerosmith guitarist Joe
Perry headlined the annual Boston Pops July Fourth Esplanade concert.
Earlier this year Tyler, an icon in rock music, sustained bleeding
into a vocal cord. Years of athletic vocal performance had led to the
development of abnormal blood vessels that were predisposed to further
injury. In March, Aerosmith's current tour was cancelled so that Tyler
could have his traumatized vocal-cord vessels surgically treated by
Steven Zeitels, MD, director of the MGH Voice Center. Tyler has recovered
from the procedure, and the band is currently recording prior to their
upcoming tour, which gets underway in September.
" We previously adapted lasers that target
blood vessels for use in the treatment of precancerous vocal-cord dysplasia.
We then applied that experience to institute a new treatment strategy
for one of the most common career-stopping problems in singers, which
is vocal-cord bleeding that can also lead to the formation of benign
growths such as polyps and nodes (nodules)."
the Eugene B. Casey Chair of Laryngeal Surgery at Harvard Medical
A lifetime of singing can place vocalists at increased risk for vocal
cord injury, similar to the risk of other injuries faced by high-performance
athletes. This risk can occur with any singing style - rock, pop, opera
or music theater - and is strongly associated with high-intensity performances.
Zeitels has been treating elite singers for many years and was called
on to work with Julie Andrews after she lost her singing voice due
to a failed surgical procedure. He subsequently has collaborated with
Miss Andrews to increase awareness of voice problems and spearhead
a research project addressing her type of injury.
In treating Tyler, Zeitels utilized his group's most recent innovation,
a pulsed Potassium-Titanyl-Phosphate (KTP) laser. The standard continuous-firing
KTP laser has been utilized in the past by surgeons as a tissue-cutting
and ablating instrument. The MGH team is the first in the world to
treat vocal cords and the rest of the larynx with accurately controlled
pulses of KTP laser light. The Pulsed-KTP laser has dramatically elevated
the precision and ease of laryngeal surgical procedures by more effectively
controlling bleeding while being substantially gentler on the delicate
In scientific presentations at the American Otolaryngology meetings
in May, the MGH researchers reported successful results in treating
approximately 40 singers over the past 5 years - including Steven Tyler
and Metropolitan Opera star Carol Vaness - with laser technology that
targets blood vessels. They also reported another investigation using
the Pulsed-KTP laser to treat vocal-cord dysplasia and papillomatosis
as an office-based clinic procedure avoiding general anesthesia. This
first reliable office-based treatment of these diseases evolved from
a close collaboration between Zeitels and colleague R. Rox Anderson,
MD, director of the MGH Wellman Center for Photomedicine. Previously
the team had established the efficacy of angiolytic (targeting and
shrinking blood vessels) lasers in microsurgical treatment of vocal-cord
dysplasia with the Pulsed-Dye laser, which was also valuable for treating
"The Pulsed-KTP laser is currently the optimal angiolytic
laser for vocal cord problems. It has greatly enhanced the precision
we can perform many voice procedures, both in the operating room
accompanied by the surgical microscope and in the office treating
diseases. The Pulsed-KTP laser is an critical innovation in the instrumentation
arsenal of the laryngeal surgeon," said Zeitels.
The MGH and HMS instituted one of the first academic programs in Laryngology
in the United States in 1870. The MGH program was discontinued in the
1920s and was reestablished less than two years ago with the philanthropic
assistance of the Eugene B. Casey Foundation and the Institute of Laryngology
and Voice Restoration, a patient-based organization with the mission
to further research, clinical care and education in laryngeal and voice
disorders. The current research efforts have been catalyzed by a unique,
cooperative, and synergistic effort among these organizations.