Page 90 - Revista Portuguesa - SPORL - Vol 60. Nº3

white plaque lesion of the laryngeal mucosa possible with clear margins whenever possible.
caused by the accumulation of keratin on Patients with dysplastic lesions were followed
the epithelium . On a histological level, this regularly, every 3-6 months, with shorter
3
lesion can represent hyperplasia, dysplasia or intervals of 1-3 months in cases of severe
malignancy and around 50% of the lesions dysplasia or carcinoma in situ. Whenever a
can be pre-malignant or malignant . In new lesion was observed, a new MLS was
4
addition to this, it has been recognised that performed. Recommended minimum follow-
leucoplakia can progress to SCC even when up was 5 years for every patient independent
the histological analysis shows a benign lesion of dysplasia grade. Moreover, in cases of
without dysplasia . As such, the presence of carcinoma in situ without clear margins,
5
leucoplakia requires a histological examination patients were submitted to a cordectomy to
and these lesions should be followed carefully ensure total removal of the lesion and to rule
to allow for an earlier detection of laryngeal out the presence of SCC. When there was a SCC
cancer in cases of progression. on the cordectomy’s pathological analysis, the
The main objective of this study is to lesion was categorized as malignant.
analyse possible risk factors associated with All data was collected in March 2021 by
progression to carcinoma in benign or pre- the analysis of patients’ digital clinical
malignant vocal fold leucoplakia. information. Patients were considered
exposed to gastroesophageal reflux disease
Methods (GERD) when there was data of a previous
Observational retrospective study including diagnosis by a gastroenterologist or a
every microlaryngoscopy (MLS) performed primary care physician. A descriptive analysis
due to vocal fold leucoplakia from January 2010 was performed with relative and absolute
to December 2020 in the otorhinolaryngology frequencies for categorical variables, mean
department of a tertiary hospital centre. and standard deviation (SD) for normally
Patients with malignant histological lesions distributed continuous variables and median
or patients with a previous documentation and interquartile range for non-normally
of vocal fold dysplasia or malignancy were distributed continuous variables. Normality of
excluded. Furthermore, patients that had variables was assessed with the Kolmogorov-
performed MLS due to leucoplakia before this Smirnov test. The assessment of possible risk
period were also excluded. Every surgery was factors for progression to SCC was performed
performed by different experienced surgeons with the chi-square test or Fischer’s exact test
and pathological analysis was performed by for categorical variables and with the Student’s
different anatomopathologists from the same T test for normally distributed continuous
hospital. Lesions were classified as benign, pre- variables.
malignant or malignant and pre-malignant All statistical analysis was performed with
lesions included mild, moderate and severe the 27th version of the IBM® SPSS® Statistics
dysplasia and carcinoma in situ. Dysplasia was software and associations were considered
classified taking into consideration the World significant when p<0,05.
Health Organization (WHO) 2005 system . The Ethical approval was obtained from the
6
main outcome was progression to carcinoma. Hospital Ethics Committee (Comissão de
Treatment and follow-up in every patient Ética do Hospital de São João, E.P.E) with the
were identical and it was in accordance to number 25/2022.
the strategy used in the department. Every
patient was counselled to stop smoking and Results
to reduce alcohol consumption. Every MLS A total of 163 patients submitted to one or
was performed with cold blade instruments more MLS due to vocal fold leucoplakia were
and lesions were removed as completely as included. Histologically, 50 patients (30,7%)

246 Revista Portuguesa de Otorrinolaringologia - Cirurgia de Cabeça e Pescoço