Eckel, Hans Edmund, Simo, Ricard, Quer, Miquel ORCID: 0000-0003-2563-6729, Odell, Edward, Paleri, Vinidh, Klussmann, Jens Peter, Remacle, Marc, Sjogren, Elisabeth and Piazza, Cesare . European Laryngological Society position paper on laryngeal dysplasia Part II: diagnosis, treatment, and follow-up. Eur. Arch. Oto-Rhino-Laryn.. NEW YORK: SPRINGER. ISSN 1434-4726

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Abstract

Purpose of review To give an overview of the current knowledge regarding the diagnosis, treatment, and follow-up of laryngeal dysplasia (LD) and to highlight the contributions of recent literature. The diagnosis of LD largely relies on endoscopic procedures and on histopathology. Diagnostic efficiency of endoscopy may be improved using videolaryngostroboscopy (VLS) and bioendoscopic tools such as Narrow Band Imaging (NBI) or Storz Professional Image Enhancement System (SPIES). Current histological classifications are not powerful enough to clearly predict the risk to carcinoma evolution and technical issues such as sampling error, variation in epithelial thickness and inflammation hamper pathological examination. Almost all dysplasia grading systems are effective in different ways. The 2017 World Health Organization (WHO) system should prove to be an improvement as it is slightly more reproducible and easier for the non-specialist pathologist to apply. To optimize treatment decisions, surgeons should know how their pathologist grades samples and preferably audit their transformation rates locally. Whether carcinoma in situ should be used as part of such classification remains contentious and pathologists should agree with their clinicians whether they find this additional grade useful in treatment decisions. Recently, different studies have defined the possible utility of different biomarkers in risk classification. The main treatment modality for LD is represented by transoral laser microsurgery. Radiotherapy may be indicated in specific circumstances such as multiple recurrence or wide-field lesions. Medical treatment currently does not have a significant role in the management of LD. Follow-up for patients treated with LD is a fundamental part of their care and investigations may be supported by the same techniques used during diagnosis (VLS and NBI/SPIES).

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Eckel, Hans EdmundUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Simo, RicardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Quer, MiquelUNSPECIFIEDorcid.org/0000-0003-2563-6729UNSPECIFIED
Odell, EdwardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paleri, VinidhUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klussmann, Jens PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Remacle, MarcUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sjogren, ElisabethUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Piazza, CesareUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-315079
DOI: 10.1007/s00405-020-06406-9
Journal or Publication Title: Eur. Arch. Oto-Rhino-Laryn.
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1434-4726
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SQUAMOUS INTRAEPITHELIAL LESIONS; EARLY GLOTTIC CANCER; CARCINOMA-IN-SITU; ENDOSCOPIC CORDECTOMY; TRANSORAL CO2-LASER; LASER-SURGERY; DAILY ASPIRIN; RADIOTHERAPY; HEAD; NECKMultiple languages
OtorhinolaryngologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/31507

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