Management of laryngeal precancerous lesions

Auris Nasus Larynx. 2012 Jun;39(3):280-3. doi: 10.1016/j.anl.2011.08.002. Epub 2011 Aug 20.

Abstract

Objective: The identification of precancerous lesions is the basis of an early diagnosis, and of a treatment that allows, in the great part of cases, the preservation of organ functions. The aims of this study were: the evaluation of the less invasive treatment for precancerous lesion of the larynx to minimize the recurrences, the estimation of number of further operation required.

Methods: A prospective study was done on patients with clinical diagnosis of laryngeal precancerosis. The patients were treated by a transoral endoscopic approach with direct microlaryngoscopy (DML) doing an excision-biopsy with cold blade, consisting in excision of the whole visible lesion with vocal ligament preservation.

Results: A recurrence of a clinically evident precancerous lesion was present in 13.2% of patients that had a laryngeal intraepithelial lesion (LIN) 1 lesion and in 28.95% of patients that had a LIN 2 lesion.

Conclusion: In order to achieve a control of a precancerous lesion, we suggest: excisional biopsy/subepithelial cordectomy (type 1 cordectomy) for LIN 1 lesions and subligament cordectomy (type 2 cordectomy) in case of LIN 2 cases. In case of recurrences of LIN 1 lesion we suggest directly a type 2 cordectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Female
  • Humans
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laryngoscopy / methods*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / prevention & control*
  • Precancerous Conditions / pathology
  • Precancerous Conditions / surgery*
  • Prospective Studies
  • Treatment Outcome