title: Management of laryngeal precancerous lesions.
abstract: OBJECTIVE
  The identification of precancerous lesions is the basis of an early diagnosis, and of a treatment that allows, in the great part of cases, the preservation of organ functions. The aims of this study were: the evaluation of the less invasive treatment for precancerous lesion of the larynx to minimize the recurrences, the estimation of number of further operation required.
  
  
  METHODS
  A prospective study was done on patients with clinical diagnosis of laryngeal precancerosis. The patients were treated by a transoral endoscopic approach with direct microlaryngoscopy (DML) doing an excision-biopsy with cold blade, consisting in excision of the whole visible lesion with vocal ligament preservation.
  
  
  RESULTS
  A recurrence of a clinically evident precancerous lesion was present in 13.2% of patients that had a laryngeal intraepithelial lesion (LIN) 1 lesion and in 28.95% of patients that had a LIN 2 lesion.
  
  
  CONCLUSIONS
  In order to achieve a control of a precancerous lesion, we suggest: excisional biopsy/subepithelial cordectomy (type 1 cordectomy) for LIN 1 lesions and subligament cordectomy (type 2 cordectomy) in case of LIN 2 cases. In case of recurrences of LIN 1 lesion we suggest directly a type 2 cordectomy.
authors.affiliation: Dipartimento Biomedicina e Neuroscienze Cliniche - U.O. Otorinolaringoiatria, Università degli Studi di Palermo, Italy. francesco.dispenza@gmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Dispenza
authors.forename: Alessandro
authors.initials: A
authors.lastname: De Stefano
authors.forename: Donatella
authors.initials: D
authors.lastname: Marchese
authors.forename: Francesco
authors.initials: F
authors.lastname: Martines
authors.forename: Carlo
authors.initials: C
authors.lastname: Dispenza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D011230:Precancerous Conditions / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome