Biopsy, or Not to Biopsy—That is the Question: Management of Vocal Fold Leukoplakia

Sunday, September 29, 2024

1:00 PM – 2:00 PM EDT

Location: MBCC, 244-245

CME/MOC Credit: 1

Disclosure(s):

Christopher D. Dwyer, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

R. Jun Lin, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

PROGRAM DESCRIPTION: Vocal fold epithelial disease can represent a spectrum of pathologies, including infectious and neoplastic processes, ranging from benign disease to invasive carcinoma. While many of these epithelial diseases often appear as “leukoplakia”, management principles vary depending on the lesion’s appearance and pathologic diagnosis. Vocal fold leukoplakia lesions are often initially identified by general otolaryngologists, and thus decision making on how to manage these lesions, especially with respect to biopsy and possible excision, is of importance.

We present a series of case examples with an expert panel discussing various approaches, surgical techniques and treatment options that are generally employed. Questions from the audience will be encouraged, and active participation promoted using real-time live pole questions. Topics to be covered include diagnostic work-up and imaging techniques for vocal fold epithelial disease; risk of malignant transformation of pre-malignant epithelial lesions; pathologic classification of benign, dysplastic, pre-malignant and malignant disease; surgical biopsy and excisional techniques (cold-steel, CO2 laser, KTP laser, blue laser, extended cordectomy); as well as management of recurrent and recalcitrant leukoplakia lesions following prior treatment/excision.

Panelists will reference and review the available literature surrounding vocal fold leukoplakia to meet the session objectives

Learning Objectives:

After actively participating in the workshop, participants will be able to distinguish between leukoplakic epithelial lesions that can be safely observed and those that should be considered for biopsy.
Appreciate the various settings in which a vocal fold biopsy can be obtained (in office vs operative room) and select a surgical technique (complete excision, representative biopsy, surgical ablation), that balances diagnostic and therapeutic goals, while optimizing voice preservation.
Interpret the various pathologic diagnoses, appreciate the dilemmas and limitations associated with pathologic diagnosis considering the specimen sampled, and counsel patients on biopsy results and suggest reasonable treatment options.

Moderator(s)

CD

Christopher D. Dwyer, MD

Instructor
Brigham and Women's Hospital Harvard University
Boston, MA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Panelist(s)

R. Jun Lin, MD

Assistant Professor
University of Toronto
Toronto, ON, Canada

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
AL

Andrée-Anne Leclerc, MD MSc

Professeure Adjointe
University de Montreal
Montreal, QC, Canada

Disclosure information not submitted.