Vocal fold leukoplakia: An experience of a tertiary care teaching hospital of Eastern India

Abstract

Background: Vocal fold leukoplakia (VFL) is a term used to document a white patch on the mucosa of the vocal folds. It is caused by prolonged use of smoking, consumption of alcohol, excessive drying, or voice abuse and is considered premalignant lesion of the larynx. Aim: The study aims to analyze the demographic and clinical parameters, pathological findings, and management of VFL patients, as well as the incidence of laryngeal cancer among these patients. Materials and Methods: We retrospectively collected 92 VFL patients who received treatment during November 2015 to December 2018 and followed up for a minimum period of 2 years up to December 2020. The detail clinical characteristics including endoscopic findings, postoperative pathological findings, and management were assessed from the patient's file. Results: The mean age of presentation was 64.3 years, with 52 male and 40 female patients. We found cigarette smoking as the most common etiological factor, which was seen in 45 patients (48.91%) followed by alcohol consumption and laryngopharyngeal reflux. Seventy-seven patients underwent surgery (42: carbon dioxide laser excision and 35: coblation-assisted excision), and rest 15 patients treated conservatively. On postoperative, the different pathological variants encountered were nondysplasia (n = 41); low-grade dysplasia (n = 24); high-grade dysplasia (n = 5); carcinoma in situ (n = 4); and invasive carcinoma (n = 3). Factors such as age (P < 0.001) and morphological types (P = 0.043) have been significantly correlated with pathological grades of VFL. Conclusion: The invasive laryngeal cancer detection rate underlying VFL at first diagnosis was 3.90%. The early diagnosis of VFL and treatment are challenge for clinicians to decrease the incidence of laryngeal malignancy. The patient's age and morphological types may guide treatment of VFL due to risk stratifications.