Vocal fold scars: a common classification proposal by the American Laryngological Association and European Laryngological Society

Eur Arch Otorhinolaryngol. 2019 Aug;276(8):2289-2292. doi: 10.1007/s00405-019-05489-3. Epub 2019 May 29.

Abstract

Purpose: Vocal fold scar is one the most challenging benign laryngeal pathologies. The purpose of this paper is to propose a classification that will allow for a common description of this entity between laryngologists, prevent discrepancies in interpretation, allow for comparison of related studies, and offer a training tool for young laryngologists.

Methods/results: Based on the depth and laterality of scarring, we propose 4 types: type I, characterized by atrophy of lamina propria with/without affected epithelium; type II, where the epithelium, lamina propria, and muscle are affected; type III, where the scar is located on the anterior commissure; type IV, which includes extended scar formation in both anteroposterior and rostro-caudal axis with significant loss of vocal fold mass.

Conclusion: We believe that our proposal is comprehensive and encompasses all existing iatrogenic and non-iatrogenic etiologies in a simple and concise manner. It also serves its purpose as a descriptive, comparative, and training tool.

Keywords: American Laryngological Association; Benign laryngeal pathology; Classification proposal; European Laryngological Society; Vocal fold scar.

MeSH terms

  • Cicatrix / classification*
  • Cicatrix / pathology*
  • Epithelium / pathology
  • Humans
  • Laryngeal Diseases / classification*
  • Laryngeal Diseases / etiology
  • Laryngeal Diseases / pathology
  • Mucous Membrane / pathology
  • Vocal Cords / pathology*
  • Vocal Cords / surgery