Dysplasia (pre-cancer) of the vocal cords can result in hoarseness and often presents as white patches (leukoplakia) or red patches (erythroplasia) on one or both vocal cords. Vocal cord carcinoma-in-situ (CIS) can be thought of as very severe dysplasia, and it essentially represents the last step before a pre-cancerous process transitions into vocal cord cancer.
By definition, vocal cord dysplasia and even vocal cord CIS are confined to the surface membrane of the vocal cords and do not invade the deeper vibratory tissues. Aggressive surgical treatment, such as “vocal cord stripping,” may not necessarily cure this disease and can result in worsening of the voice by scarring the vibratory layer below the diseased vocal cord surface. Watchful waiting without treatment, however, carries an approximately 10 to 30 percent chance of transformation into cancer, according to pooled data available in the medical literature.
An optimal initial treatment strategy involves careful surgical excision of the diseased surface of the vocal cords in the operating room without injury to the crucial vibratory layer beneath. This process is greatly aided by use of the KTP laser, which is preferentially attracted to the abnormally increased blood supply that is inherent to many forms of this disease. In fact, meticulous surgical management not only reduces the chance of progression into cancer, but it can also potentially improve the voice.
In some cases, even with optimal surgical treatment, vocal cord dysplasia can be a chronic disease that recurs. Rather than returning to the operating room, many of these recurrences can be treated in the office with the KTP laser, thereby minimizing the need for repeated general anesthesia.