Leukoplakia.[FIGURE OMITTED] Ten years prior to our evaluation, a 73-year-old woman had had a lesion removed from her vocal fold; the lesion had been histologically diagnosed as a laryngeal papilloma papilloma /pap·il·lo·ma/ (pap?il-o´mah) a benign tumor derived from epithelium.papillo´matous fibroepithelial papilloma a type containing extensive fibrous tissue. . She experienced no further problems during the intervening years until she began to become progressively hoarse 3 months prior to presentation. Examination under anesthesia examination under anesthesia Orthopedics A format for testing joint integrity and ROM with the Pt anesthetized Pros Examinations on awake Pts have poor interobserver/intraobserver reproducibility Cons Intensity of Sx can't be assessed. See Laxity test, Provocative test. with a 0[degrees] endoscope detected white sessile lesions on the right vocal fold and some areas of polypoid change (figure, A). An area of reactive traumatic mucosal thickening was seen on the lower lip of the left vocal fold. Examination with a 70[degrees] endoscope delineated the extent of the lesion and revealed that the ventricle ventricle /ven·tri·cle/ (ven´tri-k'l) a small cavity or chamber, as in the brain or heart.ventric´ular ventricle of Arantius the rhomboid fossa, especially its lower end. was free of disease (figure, B). Excisional biopsy of the lesion revealed moderate to severe dysplasia. White lesions on the vocal fold can represent anything from accumulations of mucus to carcinoma, so a thorough investigation to obtain a proper diagnosis is essential. Videostroboscopy is an important component of this evaluation. Mucus can usually be cleared with coughing. Fungal infections are rarely unilateral, and they often involve other parts of the larynx in addition to the vocal fold. Limitation of the mucosal wave may be associated with infection and inflammation (including that caused by reflux), but it should improve with treatment. White lesions that persist after medical therapy represent leukoplakia leukoplakia /leu·ko·pla·kia/ (-pla´ke-ah) 1. a white patch on a mucous membrane that will not rub off. 2. oral l. atrophic leukoplakia lichen sclerosus in females. , and usually they should be excised for histologic analysis. Once malignancy has been ruled out with a biopsy, maintenance photoangiolysis therapy with the pulsed dye laser may be appropriate in selected patients with recurrent leukoplakia. Lesions that do not resolve or that progress despite treatment should undergo repeat excisional biopsy. Robert Eller, MD; Mary Hawkshaw Hawkshaw implacable detective with photographic memory. [Br. Lit.: The Ticket-of-Leave Man, Barnhart, 546] See : Sleuthing , RN, BSN, CORLN; Robert T. Sataloff MD, DMA From the Department of Otolaryngology-Head and Neck Surgery, Wilford Hall Medical Center, Lackland Air Force Base Lackland Air Force Base (lăk`lənd), U.S. military installation, c.6,835 acres (2,766 hectares), S Tex., W of San Antonio; est. 1941. It is a major air force training center. , San Antonio, Tex. (Dr. Eller); the American Institute for Voice and Ear Research, Philadelphia (Ms. Hawkshaw and Dr. Sataloff); and the Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine Drexel University College of Medicine is the medical school of Drexel University. It represents the consolidation of two venerable medical schools: the nation's first medical school for women and the first U.S. college of homeopathy. Residency Locations St. , Philadelphia (Ms. Hawkshaw and Dr. Sataloff). |
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