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A new classification of vocal fold leukoplakia by morphological appearance guiding the treatment
Authors:Changjiang Li  Na Zhang  Shuyi Wang  Lei Cheng  Jian Chen
Affiliation:1. Department of Otorhinolaryngology-Head and Neck Surgery (Shanghai Key Clinical Disciplines of Otorhinolaryngology), Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai, People’s Republic of China;2. Department of Otorhinolaryngology-Head and Neck Surgery, First Central Hospital, Otorhinolaryngology Institute of Tianjin, Tianjin, People’s Republic of China
Abstract:Objective: To provide a reference for classification and treatment of vocal cords leukoplakia.

Methods: 640 cases of patients with vocal cords leukoplakia were divided into three groups based on the appearances. There were respectively 81 smooth flat lesions, 155 smooth hypertrophy lesions and 13 rough lesions were treated with conservative methods and 26, 153 and 212 cases were resected surgically for biopsy.

Results: A majority of smooth flat leukoplakia lesions were cured by non-operational methods and no atypical hyperplasia. Most of rough lesions were invalid and even progressed treated with conservative therapy and were severe dysplasia or canceration. Although 67.6% smooth hypertrophy lesions were cured or improved by conservative methods and 47% lesions had no or mild dysplasia, over 30% of lesions were still invalid or progressed and over 50% had moderate, severe dysplasia and canceration. By statistical analysis, the appearance of leukoplakia was concordant with pathological changes.

Conclusions: It is suggested that smooth flat vocal cords leukoplakia could be treated with conservative methods and rough lesions should be resected operationally, while for smooth hypertrophy vocal cords leukoplakia could be first followed-up and then adopt measures based on the appearance changes.

Keywords:Vocal cords leukoplakia  classification  morphological appearance  treatment
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