Morphology, Vibratory Function, and Vascular Pattern for Predicting Malignancy in Vocal Fold Leukoplakia.

Area of Science:

• Otolaryngology
• Oncology
• Medical Imaging

Background:

• Vocal fold (VF) leukoplakia requires accurate differentiation between benign and malignant conditions.
• Clinical features play a crucial role in predicting the nature of VF leukoplakia.
• Early and accurate diagnosis is essential for effective patient management.

Purpose of the Study:

• To evaluate clinical features of VF leukoplakia for predicting malignancy.
• To assess the diagnostic value of laryngovideostroboscopy and narrow-band imaging (NBI) in differentiating VF lesions.
• To identify key indicators of high-risk VF leukoplakia.

Main Methods:

• Analysis of 57 patients with 84 VF lesions prior to laryngeal microsurgery.
• Evaluation of lesion texture, color, thickness, size, and surrounding mucosa vascularization using NBI.
• Assessment of VF vibratory function via laryngovideostroboscopy and calculation of AUC using ROC curves.

Main Results:

• Histopathology confirmed malignancy in 13 lesions; 71 were benign or low-grade dysplasia.
• Non-homogenous color, irregular texture, and prominent thickness significantly predicted malignancy (P < 0.05).
• Absence of mucosal wave (AUC=0.927) and horizontal vessel loops on NBI (AUC=0.993) were highly significant indicators of malignancy.

Conclusions:

• Comprehensive clinical assessment combining laryngovideostroboscopy and NBI effectively differentiates low- and high-risk VF leukoplakia.
• Perpendicular vascular patterns and limited/absent mucosal waves are potent indicators of malignancy.
• This approach aids in stratifying patients for appropriate treatment and follow-up.