Risk Factors and Diagnostic Methods in Vocal Cord Mucosal Lesions

This study was an examination of malignancy risk determined according to clinical characteristics and preoperative diagnosis in vocal cord lesions compared with the definitive pathology results.

This was a retrospective study of the files of patients who were admitted to a clinic due to hoarseness and/or a laryngeal lesion and underwent a suspension laryngoscopy (SL) between 2014 and 2018. The patient files were examined and the parameters of age, gender, smoking status, alcohol use, and the site of the lesion were compared for the risk of malignancy. The details of the preoperative diagnoses, peroperative findings, and definite pathology results were evaluated for agreement.

In all, 296 cases were reviewed. Since some patients had undergone multiple SL procedures, only the final pathology results of these patients were included in the study and the final total was 260 patients. The study population consisted of 191 (73.5%) male and 69 (26.5%) female patients. Of the group, 169 (65%) were smokers and 13 (5%) consumed alcohol. The lesions were left-sided in 106 (40.8%), right-sided in 120 (46.2%), and bilateral in 34 (13.1%) cases. A total of 68 (26.2%) cases were malignant, 165 (63.5%) were benign, and 27 (10.4%) were determined to be premalignant. Analysis of patient age revealed that the risk of malignancy was significantly higher in patients in the fifth or sixth decade of life (p<0.001). Examination of gender and the risk of malignancy indicated that 64 (94.1%) of the malignant patients were male and 4 (5.9%) were female (p<0.001). It was also found that 64 of the malignant patients (94.1%) were smokers (p<0.001). Only 8 (11.8%) of the patients with malignant lesions used alcohol, and no significant relationship was found (p=0.018). The association of malignancy with the lesion site was similar (p=0.89). Logistic regression analysis determined that male gender increased the risk of malignancy 6.45% and smoking increased the risk 7.81%.

Microscopic examination of the lesion and palpation are very important in the diagnosis of patients with hoarseness and laryngeal lesion. Smoking, advanced age, and male gender increased the risk of malignancy of vocal cord lesions.