Classification of vocal fold leukoplakia by clinical scoring

Fang, Tuan‐Jen; Lin, Wan‐Ni; Lee, Li‐Yu; Young, Chi-Kuang; Chang, Kai‐Ping; Liao, Chun‐Ta; Li, Hseuh-Yu; Yen, Tzu‐Chen

doi:10.1002/hed.24368

Cited by 40 publications

(46 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For decades, laryngeal leukoplakia has been regarded as a very controversial issue, concerning the classification, histological assessment and treatment of these lesions [5,10]. Currently, there is no ideal histological grading system for premalignant laryngeal lesions.…”

Section: Discussionmentioning

confidence: 99%

“…After thorough examination of the white plaque, long-term observation should be conducted in selected cases [14]. According to Tuan-Jen Fang et al, in suspected benign lesions, observation or superficial excision is preferred; however, deeper excision is reserved for cases with malignant potential [5]. The vocal leukoplakia with the appearance of an irregular surface and redness should be managed more aggressively than those without these features, especially in older patients [5].…”

Section: Discussionmentioning

confidence: 99%

“…The main methods include: conservative therapy (strict voice rest, inhaled glucocorticoid therapy and empiric PPI), stripping of mucosa, surgical biopsies by cold instrument or laser CO 2 , partial subepithelial or subligamental cordectomy or even radiation [1,5] The choice of method is crucial to find a balance between a functional and oncological outcome.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Narrow-band imaging (NBI) for improving the assessment of vocal fold leukoplakia and overcoming the umbrella effect

et al. 2017

View full text Add to dashboard Cite

BackgroundIt is crucial to find a balance between functional and oncological outcome when choosing an adequate method for the management of vocal fold leukoplakia. Therefore, a detailed examination is a milestone in the decision-making process.AimTo examine whether narrow-band imaging (NBI) can be helpful in vocal fold assessment in the case of leukoplakia and how to overcome the “umbrella effect”- understood as the submucosal vascular pattern hidden under the plaque.Material and methodsProspective cohort of 41 consecutive patients. Inclusion criteria: vocal fold leukoplakia, no previous procedures (surgery, radiotherapy), and preoperative endoscopy with an optical filter for NBI. Two groups: “suspicious” and “normal”, according to the submucosal microvascular pattern of peripheral regions of the mucosa surrounding the plaque, were distinguished. Patients were qualified for a full-thickness or partial-thickness biopsy, respectively. Criteria defining suspected characters were well-demarcated brownish areas with scattered brown spots corresponding to type IV, Va, Vb, and Vc NI classifications.ResultsIn 22/41 (53.7%) patients with “suspected” microvascular pattern, full-thickness biopsy was performed. Moderate and severe dysplasia was revealed in 15 type IV and 7 type Va NI patients. In 19/41 (46.3%) patients with proper NBI vessel pattern treated by partial-thickness biopsy, hyperkeratosis was diagnosed. There was a strong correlation between the NBI pattern and final histology: Chi2 (2) = 41.0 (p = 0.0000).ConclusionThe results demonstrate that NBI endoscopic assessment of the submucosal microvascular pattern of mucosa surrounding the plaque can be an effective method to categorise the risk in vocal fold leukoplakia prior to treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Narrow-band imaging (NBI) for improving the assessment of vocal fold leukoplakia and overcoming the umbrella effect

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Lee et al divided vocal fold leukoplakia into three morphological groups: superficial type, exophytic type, and ulcerative type [15]. Fang et al proposed a method to categorize the vocal fold leukoplakia based on morphologic characteristics scoring, which included thickness, texture, color, hyperemia, size, and symmetry [9]. Similarly, this study proposed a new morphological classification of vocal fold leukoplakia.…”

Section: Discussionmentioning

confidence: 99%

“…However, besides a laryngoscopic imaging scoring system established by Fang et al [9], there have been few reports about the clinical classification method of vocal fold leukoplakia to distinguish benign from malignant lesions. Thus, a method to classify the vocal fold leukoplakia can reflect the degree of lesions simply and comprehensively might be indispensable.…”

Section: Introductionmentioning

confidence: 99%

Nonsurgical Treatment for Vocal Fold Leukoplakia: An Analysis of 178 Cases

Chen

Cheng

Changjiang

et al. 2017

BioMed Research International

View full text Add to dashboard Cite

Objective To assess the effectiveness and identify vocal fold leukoplakia types appropriate for nonsurgical treatment. Methods The vocal fold leukoplakia in 178 patients was divided by gross appearance into three subtypes: flat and smooth, elevated and smooth, and rough. All patients received nonsurgical treatment including smoking and drinking cessation, voice rest, omeprazole, and Chinese medication therapy. The clinical response of three subtypes was assessed after a 6-month follow-up. Results Vocal fold leukoplakia subtypes included flat and smooth (n = 66; 37.1%), elevated and smooth (n = 103; 57.9%), and rough (n = 9; 5.0%). The rate of complete response was 80.3%, 66.0%, and 0.0% for the 3 lesion types, respectively (rough versus flat and smooth, P < 0.001; rough versus elevated and smooth, P < 0.001, Fisher's exact test). The incidence of carcinoma in rough leukoplakia was significantly higher than that in smooth leukoplakia (44.4% versus 2.4%, P = 0.002, Fisher's exact test). Clinical type was the only significant factor for clinical response of nonsurgical treatment (P = 0.005, ordinal logistic regression). Conclusions The effectiveness of nonsurgical treatment for smooth vocal fold leukoplakia is better in comparison to rough vocal fold leukoplakia. Smooth leukoplakia could be managed with nonsurgical treatment; more aggressive treatments should be considered for rough leukoplakia.

show abstract