Vocal fold leukoplakia – An underestimated premalignant lesion of the larynx: A narrative review

Abstract

Vocal fold leukoplakia is the clinical term for a whitish patch on the vocal fold mucosa. It is caused by prolonged tobacco smoking, consumption of alcohol, and excessive drying or vocal abuse. Histopathologically, it displays varying degrees of dysplasia and hyperkeratosis. The presence of dysplastic cells in the vocal fold leukoplakia denotes a premalignant lesion. The common clinical presentations of vocal fold leukoplakia include hoarseness of voice, foreign-body sensation, and irritation in the throat. The prognosis of this lesion is uncertain, and it can vary from a non-dysplastic leukoplakia to a squamous cell carcinoma. Early diagnosis and treatment of vocal fold leukoplakia are often challenging, and its management includes excision of the lesion, close follow-up, and avoiding exposure to risk factors such as tobacco smoking and alcohol consumption. For this review, we identified 134 articles from the Scopus, PubMed, Cochrane, and Medline databases and Google Scholar using the search terms, “vocal fold leukoplakia,” “premalignant diseases of the larynx,” “laryngeal keratosis,” “vocal cord leukoplakia,” “glottis,” and “precancerous lesions of glottis.” A total of 52 articles were included in the review. We aimed to assess the epidemiology, etiopathology, clinical presentation, diagnosis, and the current treatment options of vocal fold leukoplakia.