Targeted laryngeal photodynamic therapy with a balloon diffusing light source.

Photodynamic therapy (PDT) has been used for pre-malignant mucosal lesions. In an attempt to treat a patient with recurrent high-grade dysplasia of the glottic larynx, we were faced with technical challenges leading us to abandon the classic microlens fiber for a 2-cm long translucent diffusing balloon catheter to deliver photoactivating light to the targeted lesion. Real-time measurements confirmed stable photobleaching with augmentation of the prescribed light fluence secondary to light scatter in regions not in contact with the balloon diffuser. We report a potential new application of the balloon catheter that may be more suitable for anterior glottic lesions associated with minimal acute toxicity.