Vocal Fold Leukoplakia: Which of the Classifications of White Light and Narrow Band Imaging Most Accurately Predicts Laryngeal Cancer Transformation? Proposition for a Diagnostic Algorithm

摘要

The management of Vocal Fold Leukoplakia, especially distinguishing malignant leukoplakia and early glottic carcinoma from benign lesions pose a challenge for laryngologists. In this two-center study we have attempted to select the most accurate classification for predicting low- and high-risk Vocal Fold Leukoplakia in White Light Imaging and Narrow Band Imaging and to establish a diagnostic algorithm with a timely referral for treatment. We have shown that both the plaque image and the microvascular pattern on the leukoplakia periphery are critical in the diagnosis of high-risk Vocal Fold Leukoplakia. The proposed algorithm combines both imaging techniques to show the added value of Narrow Band Imaging and indicates the solution for non-users.