To our knowledge only a few defined studies have been carried out on laryngeal cysts. These cysts represent a mixed group of benign laryngeal lesions that can cause diagnostic and therapeutic difficulties. The aim of this study was to characterize their histological structure and localizations in the larynx as well as to discuss theories about their genesis. Between 1973 and 1996, 342 laryngeal cysts were treated at Phillips University of Marburg, while from 1990 to 1996, 74 were treated at Justus Liebig University of Giessen. In all, 416 laryngeal cysts were treated by endolaryngeal microsurgery. All clinical charts were reviewed retrospectively and surgical specimens examined histomorphologically. Findings showed that 58.2% of the laryngeal cysts were located in the glottic area and 18.3% in the ventricular folds. The remainder were located on the aryepiglottic fold (2.2%) and interarythenoid region (0.7%). Two congenital cysts were also treated. Approximately 56% of the laryngeal cysts were lined by squamous cell epithelium, 37% by respiratory epithelium and 7% by oncocytic epithelium. In general, the laryngeal cysts were found to be a collection of inhomogenous lesions from different histogenetic origins with diverse symptoms related to their site and size. On the basis of our investigations, a new classification was established concerning the genesis and development of laryngeal cysts by subdividing cysts into congenital cysts, retention cysts, and inclusion cysts.

Autofluorescence endoscopy facilitates the detection and delineation of precancerous lesions, carcinoma in situ, and microinvasive cancer of the larynx more accurately than clinical observation alone. Scarring, marked hyperkeratosis, and inflammation can limit the predictive value of the method.

OCT is a simple, rapid, and reliable aid in the diagnostic investigation and intraoperative monitoring of laryngeal disease.

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The objective of the study was to assess the epithelial thickness in different lesions of the vocal folds in order to gain more information about its influence on endoscopic imaging. Retrospective study including 161 patients undergoing surgery for a total of 206 benign and malignant lesions of the vocal folds. Laryngoscopy and autofluorescence endoscopy were the first line of investigation for these lesions. Diagnosis was confirmed by histopathology in all cases. Morphometric measurement of epithelial thickness was performed using a normal white light and an autofluorescence microscope. The vocal fold mucosa revealed a progressive thickening from normal epithelium (NE = 147 microm) over the different grades of epithelial dysplasia (EDI = 258 microm, EDII = 301 microm, CIS = 445 microm) to early invasive carcinoma (EIC = 974 microm), while benign lesions presented only a slight epithelial thickening of an additional 100 microm. In such a manner, moderate dysplasia showed a double increase, carcinoma in situ a triple increase and early invasive carcinoma even a sixfold increase of the mean epithelial thickness compared to normal laryngeal mucosa. As fluorescence inducing light has a penetration depth of approximately 300 microm, a marked loss of autofluorescence was recognized from moderate dysplasia onwards, while mild dysplasia simply revealed a slight loss of fluorescence. Autofluorescence microscopy demonstrated a threefold higher fluorescence intensity of the submucosal connective tissue compared to the epithelium, which showed always the same weak intensity independent of the grade of dysplasia. In most cases laryngeal epithelium demonstrates progressive thickening during cancer genesis leading to a loss of autofluorescence.