Management of laryngeal dysplasia: a review.
Laryngeal dysplasia is a common clinical concern. Despite major advancements in otolaryngology, a significant number of patients with the condition progress to invasive carcinoma. In the recent years, new diagnostic techniques such as autofluorescence and contact endoscopy have been applied to increase the accuracy of the laryngeal biopsies. Moreover, significant efforts have been made to correlate the histopathological appearance of the dysplastic samples to their clinical course. So far, a wide range of therapeutic strategies for different grades of dysplasia has been suggested by authors; however, there is a lack of outcome reviews. In the current review, the outcome of different therapeutic strategies for severe dysplasia and carcinoma in situ has been compared with statistical analysis. The paper also summarises the current knowledge of the alternative management methods as well as current areas of research in the chemoprevention of the condition. (1) Significant efforts have been made to develop new techniques to improve the accuracy of microlaryngoscopic assessment of laryngeal premalignancy. Comparative studies are required using microlaryngoscopy against the new techniques to evaluate their clinical utility. (2) The meta-analysis suggests a better local control rate with radiotherapy compared to other standard methods of management of dysplasia; however, functional impairment and complications associated with each of the standard treatments should be further evaluated.
Sadri
Maziar
M
Head and Neck Centre, Royal Hallamshire Hospital, Sheffield, UK. mazsadri@yahoo.com
McMahon
Jeremy
J
Parker
Andrew
A
D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D018450:Disease Progression; D006801:Humans; D006965:Hyperplasia; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D007828:Laryngoscopy; D007830:Larynx / Q000473:pathology*; D007971:Leukoplakia / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D010778:Photochemotherapy / Q000379:methods; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D018714:Radiotherapy, Adjuvant / Q000379:methods; D013050:Spectrometry, Fluorescence