Vocal Fold Leukoplakia: Cases, Controversy, and Management

PROGRAM DESCRIPTION: This panel presentation comprehensively reviews evaluation and management of vocal fold leukoplakia. Updated from prior years, this iteration will explore management strategies through focus on a case-based approach. Though "white vocal fold lesions" are common, management remains challenging – doing 'too little' may allow precancerous lesions to progress, while doing 'too much' may create unnecessary scar and dysphonia. Using cases, panel discussion, and encompassing a variety of expert opinions and surgical techniques, this panel presentation will provide a framework for balancing oncologic with functional outcomes. It will highlight challenges, controversies and emerging paradigms in vocal fold leukoplakia care.

There will be focus on surgical approaches that can be applied in current practice by any otolaryngologist, including use of KTP and CO2 lasers and also discussion of what techniques are appropriate in the absence of a laser. Discussion will also include future technologies and adjuvant care of laryngeal leukoplakia, encompassing narrow-band imaging, optical coherence tomography, chemotherapy, radiotherapy, and photodynamic therapy as they apply to current and future state-of-the-art management.

OUTCOME OBJECTIVE 1: Understand risk of laryngeal leukoplakia progression to cancer, with need to balance oncologic efficacy with function.

OUTCOME OBJECTIVE 2: Review current and emerging techniques for accurate diagnosis, staging, and surveillance of laryngeal leukoplakia.

OUTCOME OBJECTIVE 3: Discuss treatment alternatives for laryngeal leukoplakia in office and OR, mentioning KTP, CO2 and cold instrument techniques

BACKGROUND STATEMENT: Laryngeal leukoplakia management remains challenging. Do too little, and disease may progress to cancer. Do too much, and treatment may cause vocal fold scar and poor voice. This panel focuses on balancing functional and oncologic outcomes. Prior AAO-HNSF panels have been well-received.