OtoRhinoLaryngology Portal

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Leukoplakia

Leukoplakia is a white lesion of the vocal fold.  It is generally considered a premalignant lesion and needs a biopsy for confirmation.

Vocal Folds Dysplasia

Histologically-confirmed vocal folds dysplastic lesion.

Narrow Band Imaging (NBI) in Assessment of of Dysplastic Laryngeal Lesions

 

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.

Leukaplakia: Intraoperative Endoscopic Assessment

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.

Leukoplakia : Endoscopic Examination and Biopsy

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.

Laser Excisional Biopsy or Cordectomy

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]

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