Management of laryngeal precancerous lesions

• Published in: Auris Nasus Larynx
• Main Authors: DISPENZA, Francesco, MARCHESE, Donatella, MARTINES, Francesco, DISPENZA, Carlo, De Stefano, A
• Other Authors: Dispenza, F, Marchese, D, Martines, F, Dispenza, C
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier Science 2012
• Subjects: Larynx; Cancer; Precancerou; Precancerosi; Laryngoscopy; Settore MED/31 - Otorinolaringoiatria; Settore MED/32 - Audiologia; DML
• Online Access: http://hdl.handle.net/10447/103793; https://doi.org/10.1016/j.anl.2011.08.002

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 clone 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.