Leukoplakia is a white lesion of the vocal fold. It is generally considered a premalignant lesion and needs a biopsy for confirmation.
The above figures show the application of narrow band imaging for the purpose
of intra-operative assessment of pre-malignant and early cancerous laryngeal lesions. It is a useful adjunctive diagnostic procedure to enable a subtle lesion to appear more obvious for a targeted biopsy or surgical excision.
Circle indicates the suspicious dysplastic lesion.
Endoscopic examination performed for detail assessment and documentation prior to cordectomy. 0 and 70 degree rigid endoscopes are commonly used with the latter visualize the inferior view of vocal fold and anterior subglottic/anterior commissure area.
The appearance of right vocal fold after subepithelial CO2-laser cordectomy.
A well-define leukoplakia of right true vocal fold.
70 degree endoscopy view.
Side view of the lesion. A prominent feeder vessels seen posteriorly.
The view after excisional biopsy which was performed by using cold instruments.
Right vocal fold dysplasia appearance before [top - left] and after [top - right] type I (subepithelial) cordectomy. Normal re-epithelialization occurs and voice is preserved. The intention of surgery is both diagnostic and therapeutic.
If histopathology result reveals micro-invasion or frank carcinoma, subsequent type III cordectomy will be performed or alternatively radiotherapy given. If no malignant change seen, it will be left alone and follow-up given at interval for monitoring.
[L - left, R - right, TVF - true vocal fold, arrow - anterior commissure]