title: Proposal for a descriptive guideline of vascular changes in lesions of the vocal folds by the committee on endoscopic laryngeal imaging of the European Laryngological Society.
abstract: In the last decades new endoscopic tools have been developed to improve the diagnostic work-up of vocal fold lesions in addition to normal laryngoscopy, i.e., contact endoscopy, autofluorescence, narrow band imaging and others. Better contrasted and high definition images offer more details of the epithelial and superficial vascular structure of the vocal folds. Following these developments, particular vascular patterns come into focus during laryngoscopy. The present work aims at a systematic pathogenic description of superficial vascular changes of the vocal folds. Additionally, new nomenclature on vascular lesions of the vocal folds will be presented to harmonize the different terms in the literature. Superficial vascular changes can be divided into longitudinal and perpendicular. Unlike longitudinal vascular lesions, e.g., ectasia, meander and change of direction, perpendicular vascular lesions are characterized by different types of vascular loops. They are primarily observed in recurrent respiratory papillomatosis, and in pre-cancerous and cancerous lesions of the vocal folds. These vascular characteristics play a significant role in the differential diagnosis. Among different parameters, e.g., epithelial changes, increase of volume, stiffness of the vocal fold, vascular lesions play an increasing role in the diagnosis of pre- and cancerous lesions.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Otto-von-Guericke-University of Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany. christoph.arens@med.ovgu.de.
authors.forename: Christoph
authors.initials: C
authors.lastname: Arens
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Piazza
authors.affiliation: Faculty of Medicine, University of Lisboa, Lisbon, Portugal.
authors.forename: Mario
authors.initials: M
authors.lastname: Andrea
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Frederik G
authors.initials: FG
authors.lastname: Dikkers
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Robin E A
authors.initials: RE
authors.lastname: Tjon Pian Gi
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Otto-von-Guericke-University of Magdeburg, Leipziger Strasse 44, 39120, Magdeburg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Voigt-Zimmermann
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Genoa, Genoa, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Peretti
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D007822:Laryngeal Neoplasms / Q000098:blood supply* / Q000473:pathology* / Q000601:surgery; D007828:Laryngoscopy; D062048:Narrow Band Imaging; D030361:Papillomavirus Infections / Q000473:pathology* / Q000601:surgery; D017410:Practice Guidelines as Topic; D012141:Respiratory Tract Infections / Q000473:pathology* / Q000601:surgery; D014827:Vocal Cords / Q000098:blood supply* / Q000473:pathology*
keywords: Carcinoma; Endoscopy; Superficial vascular lesions; Vascular loops; Vocal fold