White patches can be seen in the middle of the left anterior vocal cord, mostly laryngeal leukoplakia; nasopharyngeal elevation may be related to adenoid hyperplasia, pharyngeal cyst cyst, nasopharyngeal carcinoma and other diseases.
1. Laryngeal leukoplakia: it is incomplete keratinization and hyperplasia of laryngeal epithelium. When it occurs in the middle and front of the left vocal cord, the mucosal surface can be seen as white flaky elevation, which is limited in scope and not easy to be wiped off. The etiology of this disease is not clear, generally associated with chronic inflammatory stimuli, including: smoking, alcohol, improper use of voice, chronic laryngitis, viral infections, reflux pharyngitis and vitamin deficiency.
2. Nasopharyngeal bulge
(1) Adenoid hyperplasia: it is located at the midline of the posterior wall of the nasopharyngeal roof, which is a part of the inner ring of the pharyngeal lymphatic ring. Under normal physiological conditions, it develops to the maximum at the age of 6-7, gradually shrinks after puberty, and basically disappears in adults. If there is hyperplasia of this tissue, the nasopharyngeal bulge can be observed under endoscopy.
(2) Pharyngeal cyst: located at the top of the nasopharynx, deep in the pharyngeal cranial base fascia. When the top of the notochord degenerates and retracts, the epithelium of the pharynx sinks inward, forming a cystic blind fossa called pharyngeal cyst. A cyst can form if there is blockage of the external port of the pharyngeal sac. The sign of nasopharyngeal elevation can be found during nasopharyngoscopy.
(3) Nasopharyngeal cancer: It is mainly related to heredity, viral infection and environmental factors. Nasopharyngeal carcinoma often occurs in pharyngeal crypt and posterior wall of nasopharyngeal apex, which often shows small nodular or granuloma-like elevation, with rough and uneven surface, easy to bleed, and sometimes manifests as submucosal elevation with smooth surface.
When the above signs are found on examination, the doctor can be consulted to standardize the diagnosis and treatment.