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Laryngeal dysplasia: an evidence-based flowchart to guide management and follow up

Published online by Cambridge University Press:  10 April 2015

B Cosway  and
V Paleri
B Cosway*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Freeman Hospital, Newcastle Upon Tyne, UK
V Paleri
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Freeman Hospital, Newcastle Upon Tyne, UK
*
Address for correspondence: Mr Benjamin Cosway, Department of Otolaryngology, Head and Neck Surgery, Freeman Hospital, Newcastle Upon Tyne, UK E-mail: Benjamin.Cosway@newcastle.ac.uk
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Abstract

Background:

Laryngeal dysplasia is an important pre-malignant lesion. In 2010, a consensus statement by ENT surgeons and pathologists was published outlining the management and follow up of patients with laryngeal dysplasia.

Objective:

After reviewing these guidelines, we noted the need for a flowchart for laryngologists to improve efficiency in managing dysplasia and encourage adherence to evidence-based protocols.

Result:

A diagram has been produced to aid other ENT units around the country.

Keywords

LarynxVocal CordsPrecancerous ConditionsLaryngeal Neoplasms

Information

Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 6 , June 2015 , pp. 598 - 599
Copyright
Copyright © JLO (1984) Limited 2015 

Introduction

Laryngeal dysplasia is an important pre-malignant lesion that occurs in 2–10 people per 100 000 of the population.Reference Bouquot and Gnepp1 The rate of malignant transformation has been shown to be 14 per cent, with a mean time to transformation of 5.8 years and this risk rises with increasing severity of dysplasia.Reference Weller, Nankivell, McConkey, Paleri and Mehanna2 In 2010, a consensus statement by ENT surgeons and pathologists was published outlining the management and follow up of patients with laryngeal dysplasia.Reference Mehanna, Paleri, Robson, Wight and Helliwell3

Objective

After reviewing the laryngeal dysplasia guidelines, we noted the need for a flowchart for laryngologists that is easy to refer to, which could be placed in clinic rooms to improve efficiency in managing dysplasia and encourage adherence to the latest evidence-based protocols.

Result

We have produced a diagram (Figure 1) that we hope will be helpful to other ENT units around the country.

Fig. 1

Evidence-based flowchart to guide (a) management and (b) follow up of laryngeal dysplasia. CO2 = carbon dioxide; CIS = carcinoma in situ; T1 = tumour grade 1; WHO = World Health Organization

References

1Bouquot, JE, Gnepp, DR. Laryngeal precancer: a review of the literature, commentary, and comparison with oral leukoplakia. Head Neck 1991;13:488–97CrossRefGoogle ScholarPubMed
2Weller, MD, Nankivell, PC, McConkey, C, Paleri, V, Mehanna, HM. The risk and interval to malignancy of patients with laryngeal dysplasia; a systematic review of case series and meta-analysis. Clin Otolaryngol 2010;35:364–72CrossRefGoogle ScholarPubMed
3Mehanna, H, Paleri, V, Robson, A, Wight, R, Helliwell, T. Consensus statement by otorhinolaryngologists and pathologists on the diagnosis and management of laryngeal dysplasia. Clin Otolaryngol 2010;35:170–6CrossRefGoogle ScholarPubMed
Figure 0

Fig. 1 Evidence-based flowchart to guide (a) management and (b) follow up of laryngeal dysplasia. CO2 = carbon dioxide; CIS = carcinoma in situ; T1 = tumour grade 1; WHO = World Health Organization