[Laryngeal intraepithelial neoplasia]

Area of Science:

• Otolaryngology
• Oncology
• Pathology

Context:

• Laryngeal intraepithelial neoplasia (LIN), also known as laryngeal carcinoma in situ, represents a precancerous condition.
• These lesions exhibit genetic abnormalities and cellular changes similar to invasive cancer, predicting a significant risk of malignant transformation.
• Existing classifications lack universal agreement, complicating standardized diagnosis and management.

Purpose:

• To review the current understanding of laryngeal intraepithelial neoplasia (LIN), including its characteristics, risk factors, diagnosis, and treatment options.
• To compare the efficacy of various therapeutic modalities for LIN.
• To emphasize the importance of systematic follow-up for patients diagnosed with LIN.

Summary:

• LIN is a non-invasive lesion with precancerous potential, influenced by risk factors such as smoking, HPV infection, asbestos exposure, and GERD.
• Diagnostic procedures involve laryngoscopy and biopsies for histological confirmation.
• Treatment options range from observation to radiotherapy and surgical interventions, with transoral laser surgery emerging as a preferred, repeatable option offering excellent outcomes, despite radiotherapy showing high initial local control rates.

Impact:

• Highlights transoral laser surgery as the current treatment of choice for LIN due to its repeatability and excellent results.
• Underscores the higher frequency of local recurrences and potential for second primary tumors in LIN patients, necessitating diligent follow-up.
• Informs clinical practice regarding the diagnosis, management, and long-term surveillance of laryngeal precancerous lesions.