Treatment of vocal cord leukoplakia

  CO2 laser treatment for precancerous laryngeal lesions Precancerous laryngeal lesions are laryngeal disorders with malignant potential, including chronic hypertrophic laryngitis, laryngeal keratosis (also known as laryngeal leukoplakia) and laryngeal papilloma (adult type), which are generally considered to have a cancer rate of about 3-10%.  The histopathological features of pre-cancerous laryngeal lesions are the presence of varying degrees of epithelial hyperplasia and keratinization, accompanied by incomplete keratinization and papillomatous hyperplasia. It is generally believed that epithelial atypical hyperplasia can be classified into mild, moderate and severe levels. Severe atypical hyperplasia has a higher risk of carcinogenesis. From the perspective of lesion development, there are some qualitative differences between the epithelium of severe atypical hyperplasia and mild and moderate atypical hyperplasia in terms of cell proliferation and division, and the conditions for development of cancer cells in terms of cell biology. Previously, scholars generally advocate conservative treatment or “wait and see” for pre-cancerous laryngeal lesions, and then aggressive surgical treatment when the lesions become cancerous. In our opinion, since there is no reliable test index to evaluate the prognosis of the lesion, active intervention treatment at the early stage of the lesion is an important tool. The application of CO2 laser surgery to remove the lesion has good efficacy and quick recovery, which can interrupt the development process, stop the malignant development and achieve the goal of cure.  In the past 5 years, our department has treated 84 cases of chronic hypertrophic laryngitis, laryngeal keratosis, laryngeal papilloma and other pre-cancerous laryngeal lesions with CO2 laser under general anesthesia support laryngoscope, and the primary cure rate was 85.7% (72/84). 5.95% (5/84). The postoperative follow-up of 1-5 years proved that the application of CO2 laser for the treatment of pre-cancerous laryngeal lesions has the advantages of short operation time, rapid voice recovery and less recurrence.