Leukoplakia

Leukoplakia is a “white plaque” or lesion.  Leukoplakia may be present on the vocal cords and even in the mouth or throat.   Normally the skin, or epithelium, of the vocal cords is transparent.  However, when leukoplakia is present the vocal cords appear white. 

Leukoplakia of the vocal folds

Leukoplakia or 'white plaque' noted on the vocal folds. This is due to accumulation of keratin and some of the time is associated with cellular abnormalities of the vocal folds

These white patches may be keratin, which is similar to the substance found in hair or nails.  This is benign, or non cancerous. 

However, leukoplakia can represent more serious findings such

  • Dysplasia – abnormal cellular changes
  • Carcinoma in situ – cancerous cells which have not invaded (pre-cancer)
  • Cancer

It is important to biopsy and closely follow leukoplakia because of the risk of cancer.

Symptoms of leukoplakia

  • Hoarseness
  • Difficulty speaking
  • Coughing of blood
  • No symptoms – sometimes leukoplakia is found during a routine exam in which no symptoms are present.

Diagnosis of leukoplakia

Leukoplakia is diagnosed during laryngoscopy, in which a camera is either placed in the nose or the mouth to evaluate the vocal cords.

If a white patch is seen, a biopsy is performed.

Treatment of vocal cord leukoplakia

Since there is a chance that leukoplakia is associated with cancer, in most cases the leukoplakia should be biopsied during laryngoscopy.  While this may be performed in the office, it can be done in the operating room as well.  Obtaining a biopsy, or a piece of the white patch allows a pathologist to examine this carefully using a microscope for cancer. 

Laser treatment with a KTP laser is often performed after biopsy.  The laser beam is focused on the whit lesions and they are removed. This may be done in-office, in a minimally invasive fashion, or in the operating room.

In cases of dysplasia, carcinoma in situ, and cancer, close follow up is critically important.  Even after treatment with a KTP laser, the disease can progress.  As such repeat laryngoscopy and stroboscopy in the office is very important.