Section: 
Science articles
Science articlesEndoscopic diagnosis of premalignant diseases and laryngeal cancer in the phoniatric practice
Yu. E. Stepanova (1), T. V. Gotovyakhina (1), E. E. Koren’ (1), A. E. Uskov (1), D. I. Pevtsov (1)
(1) Federal State Budgetary Institution „Saint Petersburg Research Institute of Ear, Throat, Nose and Speech“ Ministry of Health of the Russian Federation, Saint Petersburg, Russia
UDK: 616.22.008.5-006-036.3-006.6-072.1
DOI: https://doi.org/10.18692/1810-4800-2017-6-128-134
ABSTRACT
Laryngeal cancer still occupies the leading position among malignant neoplasms of the upper respiratory tract. The detection of laryngeal cancer in situ occurs only in 2.3–6% of cases. It is explained by the complexity of differential diagnosis between dyskeratosis and cancer in situ of the vocal folds.
The objective of the study was to identify pathognomonic differential-diagnostic signs of videoendostroboscopic and auto-fluorescent larynx picture in the patients with premalignant diseases and early stages of the vocal folds cancer.
The study included 110 patients with premalignant diseases and suspected for early stage of laryngeal cancer. All the patients underwent biopsy of mucosa areas that caused oncological alertness. As a result, squamous cell carcinomas in situ and T1 have been detected in 58 (52.7%) patients, chronic hyperplastic laryngitis with stage 2-3 mucosa dysplasia – in 32 (29.1%), chronic hyperplastic laryngitis with metaplasia sections – 12 (10.9%) patients, benign neoplasms– 4 (3.6%), tumor-like diseases – 4 (3.6%) patients.
According to videoendostroboscopy results, most of 58 patients with cancer, 46 (79.3%) people, had no vocal fold vibrations and mucotic waves. Less frequently they were preserved, but had reduced amplitude and were irregular. During auto-fluorescent endoscopy the decrease in fluorescence intensity was observed in almost all cases – in 57 (98.3%) patients.
In 32 patients with stage 2–3 dysplasia videoendostroboscopy showed lower amplitude of the vocal folds vibration, they were irregular in 30 (93.7%) observations, mucosal wave stopped at the lesion site in 27 (84.4%) observations. Vocal folds vibrations were absent in 2 (6.3) patients. In auto-fluorescent endoscopy, the increase in fluorescence intensity was observed in most cases – in 25 (78.1%) patients.
Timely performed videoendostroboscopy in combination with auto-fluorescent larynx endoscopy provides the increase of efficacy of diagnostics of premalignant changes and early vocal folds cancer.
Publication date:
27.11.2017
Keywords:
laryngeal cancer, early diagnostics, premalignant larynx diseases, larynx videoendostroboscopy, auto-fluorescent endoscopy of larynx. For citation:
Stepanova Yu. E., Gotovyakhina T. V., Koren’ E. E., Uskov A. E., Pevtsov D. I. Endoscopic diagnosis of premalignant diseases and laryngeal cancer in the phoniatric practice. Rossiiskaya otorinolaringologiya. 2017;6:128–134. https://doi.org/10.18692/1810-4800-2017-6-128-134