[Narrow-band imaging for overcoming the microvascular pattern hidden under the plaque of the vocal fold leukoplakia]

Objective:To explore the application of narrowband imaging (NBI) in overcoming the microvascular pattern hidden under the plaque of vocal fold leukoplakia. Method:According to the morphology of intraepithelial papillary capillary loops (IPCL) around the plaque of vocal cord leukoplakia under NBI endoscopy,89 patients with microvascular morphology covered by plaque were divided into different groups. Subepithelial cordectomy was performed in 20 cases of benign group, subligamental cordectomy was performed in 45 cases of suspected malignant group, and transmuscular cordectomy was performed in 24 cases of malignant group, respectively. The lesions of vocal fold were biopsied with suspension micro-laryngoscope, and pathological examinations were also observed. Result:Pathological diagnoses showed that there were 10 cases of squamous epithelial hyperplasia, 8 cases of mild dysplasia, 21 cases of moderate dysplasia, 41 cases of severe dysplasia and carcinoma in situ, and 9 cases of invasive cancer, respectively. Spearman's analysis showed that there was a stronge positive correlation between the microvascular pattern of peripheral regions surrounding the plaque by NBI endoscopy and malignant degree of pathological classification(r=0.725, P<0.01). Conclusion:NBI endoscopy can overcome the "umbrella effect" of vocal cord leukoplakia. The microvascular morphology of the mucosa around the leukoplakia has a good correlation with final pathological diagnoses, and NBI endoscopy is helpful to determine the biopsy depth of the vocal cord leukoplakia.