In recent months, Mr. Zhang felt a foreign body in his throat and his voice has become hoarse recently, so he thought of going for a checkup to see what was going on. After an ENT examination, he found white material on his vocal cords and was diagnosed with vocal cord leukoplakia.
Vocal cord leukoplakia is a common disease in daily life, and it is also considered to be a precancerous lesion, so once it is diagnosed clearly, it needs to be treated actively and regularly. However, Dr. Wei also pointed out that vocal cord leukoplakia is still a benign disease after all, and not all leukoplakia is cancerous, so patients do not need to be overly nervous, making their mental stress too much, and be on tenterhooks. Although the exact cause of vocal cord leukoplakia is not known, as with many diseases, there are common triggers that can lead to its occurrence.
There are six main predisposing factors for vocal cord leukoplakia.
1, chronic inflammation: chronic laryngitis or inflammation of surrounding organs can repeatedly irritate the vocal folds over time.
2, acid reflux: gastric acid reflux is also so far more than a decade of otolaryngologists pay more attention to the throat acid reflux up will form stimulation of the vocal cords, naturally, is also an important reason for the vocal cords long white spots, and currently suffer from gastroesophageal reflux disease is not a few people, need to pay attention to;.
3, smoking and alcohol: vocal cord leukoplakia mainly occurs in middle-aged and elderly men, and the vast majority of patients have a history of smoking and alcohol, and long-term stimulation of the vocal cords have a close relationship.
4, speaking too much: often excessive loud speech, excessive impulse of the vocal fold mucosa, epithelial hyperplasia and hypertrophy. Therefore, for teachers, actors, businessmen and other such special groups of people who use their voices excessively, special attention should be paid to the protection of the voice.
5, fatigue immunity is low: fatigue immunity is low, any part of the body is easy to be infringed and lesions occur, for the vocal cords naturally is no exception. So for those who are busy at work or have too much fun and do not have enough rest, they should also be alert to this disease.
6, malnutrition: vitamin A, vitamin B deficiency can also cause vocal cord leukoplakia.
Hyperplastic leukoplakia should be paid great attention to
As already mentioned, vocal cord leukoplakia is considered a precancerous change, but not all leukoplakia will become cancerous, the actual cancer rate is 10%, Dr. Wei said, the difference lies in the pathological characteristics of the leukoplakia. Vocal cord leukoplakia is caused by abnormal growth and development of vocal cord mucosal tissue, and there are three pathological features: chronic inflammation, hyperplasia and keratinization. Among them, hyperplasia is what we need to pay attention to, the so-called hyperplasia means that the epithelial cells of the mucosa have increased, atypical hyperplasia especially should be paid great attention to, it is not simply cell replication, but cell heterotypes, structural disorders and abnormal differentiation, severe atypical hyperplasia is often smaller than the boundary between the tumor, may cross to cancer.
Clinical manifestations of vocal cord leukoplakia
There are two main clinical manifestations.
1. Hoarseness: Hoarseness indicates that there must be abnormalities in the vocal folds. White spots growing on the vocal folds, whether on the surface or on the edge of the vocal folds, will cause hoarseness of different degrees, which is an obvious warning signal.
2, pharyngeal foreign body sensation: there are various types of pharyngeal foreign body sensation, some patients feel like phlegm blockage, how to clear the throat can not be cleared; some patients will feel that there are ants crawling in the throat. Most patients will mistake it for chronic pharyngitis and simply treat it as pharyngitis.
Of course, the diagnosis of this disease cannot be determined simply by the patient’s physical signs, but some tests are needed. A laryngoscopy can confirm the diagnosis. There are many types of laryngoscopes available: “indirect laryngoscope, rigid tube laryngoscope, fiberoptic laryngoscope, stroboscope”, etc. All of them can reveal granular or flaky white material on the surface or edge of the vocal cords, and the boundary is clearer than the surface of the mucosa.
In addition to the white matter on the surface, otolaryngologists pay more attention to its base, whether there is obvious hyperplasia, and there is a lot of hyperplastic tissue to be especially careful. In addition, it should also be differentiated from vocal fold nodules, vocal fold polyps, vocal fold cysts, and most importantly, from laryngeal cancer.
Treatment of vocal cord leukoplakia
In terms of treatment, early leukoplakia can be treated by finding ways to treat the cause. For example, inflammation, in addition to inflammation of vocal folds, there are also inflammation of organs around vocal folds. Vocal folds show congestion and swelling, and diffuse white pseudomembranous material on the surface, which can be treated conservatively first, and after quitting smoking, alcohol and Chinese medicine treatment, and supplementing appropriate vitamins, inflammation will subside obviously, and white inflammatory exudate on the surface of vocal folds will also be reduced or disappear completely with the reduction of inflammation. Therefore, flat, smooth surface vocal cord white spots, without immediate surgery, should be based on the vocal cord white spots, the first etiological treatment, such as abstinence from smoking, alcohol, do not speak excessively, etc. and proprietary Chinese medicine treatment; patients with acid reflux take drugs such as omeprazole. After ineffective, surgery will be considered.
However, if the symptoms are more obvious and the doctor sees that the lesions of the white spots are more extensive, especially if the hyperplasia under the white spots is more obvious, this will require surgery, which is to remove the white spots under the general anesthesia microscope and can be assisted by some laser treatment. The first is to remove the lesions and restore the sound; the second is to detect cancer at an early stage in patients with more hyperplasia.
At present, ENT doctors are still very sure about the treatment of white spots, and patients should pay attention to it, but they should not worry too much. Dr. Wei said that even if the white spots become laryngeal cancer after follow-up, the treatment effect of early laryngeal cancer is still very good. Therefore, 2-3 months follow up is a must for patients with white spots.
Prevention of vocal cord leukoplakia
It is very easy for leukoplakia to recur after surgery. Since it is difficult to remove the cause of the disease, life care plays a key role in preventing leukoplakia. It is suggested that the following aspects can be implemented.
1. Quit smoking and drinking
The stimulation of tobacco and alcohol is undoubtedly, and tobacco and alcohol are not only harmful to the vocal cords, but also to many other organs, such as the gastrointestinal tract, so quit smoking and alcohol is the “leader” in the prevention of vocal cord leukoplakia. For some old smokers, you can gradually reduce the number of cigarettes, while developing other hobbies to distract their attention, such as tea, to direct their attention from the “smoke” to “tea”, so there are not a few examples of successful smoking cessation. At the same time, you can ask your family and friends to remind you to help yourself from time to time.
2, chronic diseases to be cured
If you have other related inflammatory diseases, you must actively treat other diseases. Patients with gastroesophageal reflux disease should also be cured of reflux disease and should not ignore the danger of stomach acid to the vocal cords.
3.Use vocal cords less
Usually do not speak loudly, or speak too much. For some people who need to use their vocal cords often, such as teachers and singers, they should learn to use their voices correctly and not to pull their throats to speak or sing. After work, it is more important to give your voice a rest and rest. Usually you can eat some throat-clearing and moistening foods, such as apples, pears, oranges, bananas, green radishes, tomatoes, cucumbers, cabbage, Chinese cabbage, rape, celery, spinach, honey, tofu, soy milk, eggs, etc. These light foods are good for moistening, clearing and opening the voice, and contain many vitamins and inorganic salts. Do not eat stimulating diet, such as spicy hot pot, barbecue, etc.
4.Labor and rest
White spots occur with the body’s immunity decline, so after the discovery of vocal cord white spots, life should be regular, usually to combine work and rest, do not stay up late and overworked. For people who are busy at work, learning to regulate the pace of work is also a very critical part of the workplace, long hours of work will certainly be physically and mentally exhausted, often with low efficiency, may not be able to do the best work, and if the body is broken because of the work, it is not a loss and a loss of soldiers. Therefore, learn to take time off from work, work and rest, not only to improve efficiency, but also to have a healthy body, and why not do it?
5, exercise
Exercise, is also a very good way to enhance physical fitness. As long as half an hour – 1 hour of exercise every day can be, and exercise for the purpose of exercise is to soothe the movement is good, but strenuous exercise will make the body fatigue. Therefore, older people are suitable to play tai chi, walking, while young people can jog, jump gymnastics and other sports that will not overexert the body.
In short, vocal cord leukoplakia is not a very terrible disease, as long as active treatment, close follow-up, and good life care can rest easy.