[Mucosal lesions in the larynx: predictive value of new imaging modalities for a histological diagnosis]

BACKGROUND: Optical coherence tomography (OCT) and high-frequency ultrasound are promising new methods in the early diagnosis of laryngeal cancer. However, no reliable values are given in the literature for epithelial thickness in early laryngeal cancer and its precursor lesions of the vocal folds. PATIENTS AND METHODS: In the present study, epithelial thickness in different benign and malignant lesions of the vocal folds was determined histologically using a normal white light microscope. RESULTS: The vocal fold mucosa showed progressive thickening over the different grades of dysplasia up to microinvasive carcinoma, while additional inflammation did not have any significant influence on the total epithelial thickness. In moderate dysplasia, however, the mean thickness of the epithelium was found to be double that of normal mucosa, and in severe dysplasia and carcinoma in situ, as much as three times that of normal mucosa. In the presence of microinvasive carcinoma, the average thickness of the epithelium was found to be as much as six times that in healthy mucosa. On the other hand, in case of benign lesions such as Reinke's edema, polyps, chronic laryngitis, and papillomas there was only slight epithelial thickening. CONCLUSIONS: Determination of epithelial thickness by OCT or high-frequency ultrasound may allow conclusions on whether or not a laryngeal lesion is malignant.