VOCAL CORD DYSPLASIA

Vocal cord dysplasia is a condition in which the cells of the vocal cord undergo changes and become abnormal. These abnormalities are known as “atypia” or “dysplasia”. While atypia and dysplasia are not cancer, if left untreated they can turn into a vocal cord cancer. Dysplasia of the vocal cord can appear as:

• Leukoplakia – “white plaque” on the vocal fold surface
• Erythroplakia – “red plaque”
• Keratosis – keratin, or skin like changes on the vocal cord.

Vocal cord dysplasia often prevents the vocal cords from vibrating normally, causing hoarseness.

Causes of Vocal Fold Dysplasia:
Smoking has been shown to cause dysplasia. The human papilloma virus (HPV) can cause dysplasia as well. However, many individuals with dysplasia have no identifiable cause.

Diagnosis of Vocal Fold Dysplasia:
A suspicious lesion is noted during stroboscopy. A portion of the vocal fold, or the entire vocal fold, is the only way to diagnose dysplasia is to perform a biopsy. A doctor cannot diagnose dysplasia by “looking” at the vocal fold. A biopsy is performed in the operating room during laryngoscopy.

Treatment of Vocal Fold Dysplasia
The goal of dysplasia treatment is to prevent cancer while maintaining an excellent voice. This can be a very challenging task – if one simply removes all of the abnormal tissue, not only can the lesion recur easily, the patient can be left with a hoarse voice.

Proper treatment first involves a delicate biopsy in the operating room. A representative sample of the lesion is removed, ideally from an area of the vocal fold that is not critical for voice use. A KTP laser is then used to delicately treat, or ablate, the diseased tissue.

Patients are closely followed in the office with repeat stroboscopy after the procedure as dysplasia can redevelop. If a suspicious lesion develops, and office based laser treatment may be performed. This is a fifteen to twenty minute procedure performed in the office in which a small camera is placed in the nose and a KTP laser is used to ablate the lesion. This is performed using only topical anesthetic and patients go home the same day of treatment.