Premalignant laryngeal lesions

Premalignant laryngeal lesions are classified into three classes according to the degree of atypia present: class I mild dysplasia, class II moderate dysplasia and class III severe dysplasia and carcinoma in situ. The risk that a carcinoma may develop later increases in the successive classes. The lesions are almost exclusively localized on the vocal cords. It is mandatory to remove the whole lesion for histopathological examination. A close cooperation between pathologist and laryngologist is necessary. progress in the development of more subjective and reproducible methods of grading is being made. Patients with class I and class II lesions are merely followed after an excisional biopsy. There is not a single best treatment modality for class III lesions. Radiotherapy has proven to be effective. However, the concept of microsurgical removal of the complete lesion seems to enable a more conservative approach for this class as well.