LEUKOPLAKIA

Leukoplakia is a descriptive term which means “white plaque”. Leukplakia may be present in the mouth, throat or on the vocal folds. Leukoplakia may cause symptoms such as hoarseness, or may be found incidentally during an examination.

If leukoplakia is noted during laryngoscopy and stroboscopy, it is important that it is closely observed and even biopsied if it does not resolve. Leukoplakia is due to keratin accumulation on the vocal fold.

Leukoplakia or ‘white plaque’ noted on the vocal folds. This is due to accumulation of keratin and some of the time is associated with cellular abnormalities of the vocal folds

These abnormalities may include:

• Dysplasia
• Carcinoma in-situ
• Cancer

Dysplasia, carcinoma in situ and cancer all describe abnormalities of cells, listed in order of severity. Dysplasia describes abnormality that is not cancer – however it may progress to cancer in time.

On average, approximately 50% of leukoplakia is associated with normal epithelium. However, 50% is associated with some abnormality, from dysplasia to cancer.

Management of laryngeal leukoplakia involves microlaryngoscopy and biopsy. A bisopy, or representative sample of the lesion, is obtained and processed to examine for abnormalities.

Depending on the diagnosis, treatments such as laser surgery or even additional microlaryngoscopies may be indicated. Lasers, such as the pulsed dye laser and KTP laser may be applied to a patient’s larynx for management of luekoplakia. This may be done in-office, in a minimally invasive fashion, or in the operating room. Close follow up may be recommended as well.