Surgery>>>>>Disorders of the Head and Neck
Question 1#

Which of the following are true about leukoplakia of the vocal cords?

a. Up to 40% risk of progression to invasive carcinoma
b. Ulceration is particularly suggestive of possible malignancy
c. Initial therapy includes antihistamines
d. Biopsy should be considered only after 6 months of conservative therapy

Correct Answer is B


Leukoplakia of the vocal fold represents a white patch (which cannot be wiped off) on the mucosal surface, usually on the superior surface of the true vocal cord. Rather than a diagnosis per se, the term leukoplakia describes a finding on laryngoscopic examination. The significance of this finding is that it may represent squamous hyperplasia, dysplasia, and/or carcinoma. Lesions exhibiting hyperplasia have a 1 to 3% risk of progression to malignancy. In contrast, that risk is 10 to 30% for those demonstrating dysplasia. Furthermore, leukoplakia may be observed in association with inflammatory and reactive pathologies, including polyps, nodules, cysts, granulomas, and papillomas. Features of ulceration and erythroplasia are particularly suggestive of possible malignancy. A history of smoking and alcohol abuse should also prompt a malignancy workup. In the absence of suspected malignancy, conservative measures are used for 1 month. Any lesions that progress, persist, or recur should be considered for excisional biopsy specimen.