Surgery for leukoplakia of the vocal folds
by Nupur Kapoor Nerurkar

Jaypee’s Video Atlas of Operative Otorhinolaryngology AND Head & Neck Surgery

by Vicky S Khattar, Bachi T Hathiram
About Video

This video demonstrates the microflap technique for the removal of a leukoplakic patch over the vocal fold. Here every attempt is made to maximally retain the layered microstructure of the vocal folds by preserving as much of the superficial lamina propria as possible. Since the disease is epithelial in nature, the involved epithelium has to be excised. As the latter has good propensity for regeneration, the ultimate voice quality is good if the superficial lamina propria has been preserved adequately. All excised specimens must be sent for histopathology and, if it is reported as a malignancy, an additional 2 mm margin needs to be excised. The use of the subepithelial infiltration technique is helpful in deciding the depth of infiltration of the lesion; should there be an/the area/s of the lesion that do not get elevated after this infiltration, it indicates that there is deeper infiltration of the lesion beyond the basement membrane, and that the lesion has progressed beyond a simple leukoplakia and needs to be tackled differently. This microflap technique demonstrated is in principle the same as used for excision of other benign lesions of the vocal fold.

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