Surface vascular and epithelial anatomy of the vocal folds in leukoplakia and cancer

Objective: To investigate the features of the superficial mucosa and microvascular network of the vocal cords in patients with suspected laryngeal cancer using contact endoscopy (CE). Design: A retrospective review of patients with leukoplakia and cancer of vocal cords. Main outcome measure: Fourty-two patients (mean age = 57.2 ±7.6 years), were prospectively evaluated. Eighteen had malignant lesions and 24 had leukoplakia, proven on histologic exam. Eight cancer patients and 8 patients with leukoplakia had bilateral lesions. Therefore, a total of 58 lesions (26 malignant and 32 non-malignant) was found. Contact-endoscopic imaging findings were classified into five types (I to V) based on the features of the mucosal intraepithelial capillary loops. Results: The CE-based intraepithelial papillary capillary loop classification was strongly correlated with the histological findings. Smoking habits didn’t significantly differ between patients with unilateral and bilateral lesions. Conclusions: CE imaging of the vocal cord mucosal capillaries may be useful in the early detection of laryngeal cancer and precancerous lesions.