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European Archives of Oto-Rhino-Laryngology

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Open Access 01-06-2021 | Radiotherapy | Review Article

European Laryngological Society position paper on laryngeal dysplasia Part II: diagnosis, treatment, and follow-up

Authors: Hans Edmund Eckel, Ricard Simo, Miquel Quer, Edward Odell, Vinidh Paleri, Jens Peter Klussmann, Marc Remacle, Elisabeth Sjögren, Cesare Piazza

Published in: European Archives of Oto-Rhino-Laryngology | Issue 6/2021

Abstract

Purpose of review

To give an overview of the current knowledge regarding the diagnosis, treatment, and follow-up of laryngeal dysplasia (LD) and to highlight the contributions of recent literature.

Summary

The diagnosis of LD largely relies on endoscopic procedures and on histopathology. Diagnostic efficiency of endoscopy may be improved using videolaryngostroboscopy (VLS) and bioendoscopic tools such as Narrow Band Imaging (NBI) or Storz Professional Image Enhancement System (SPIES). Current histological classifications are not powerful enough to clearly predict the risk to carcinoma evolution and technical issues such as sampling error, variation in epithelial thickness and inflammation hamper pathological examination. Almost all dysplasia grading systems are effective in different ways. The 2017 World Health Organization (WHO) system should prove to be an improvement as it is slightly more reproducible and easier for the non-specialist pathologist to apply. To optimize treatment decisions, surgeons should know how their pathologist grades samples and preferably audit their transformation rates locally. Whether carcinoma in situ should be used as part of such classification remains contentious and pathologists should agree with their clinicians whether they find this additional grade useful in treatment decisions. Recently, different studies have defined the possible utility of different biomarkers in risk classification. The main treatment modality for LD is represented by transoral laser microsurgery. Radiotherapy may be indicated in specific circumstances such as multiple recurrence or wide-field lesions. Medical treatment currently does not have a significant role in the management of LD. Follow-up for patients treated with LD is a fundamental part of their care and investigations may be supported by the same techniques used during diagnosis (VLS and NBI/SPIES).

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Title: European Laryngological Society position paper on laryngeal dysplasia Part II: diagnosis, treatment, and follow-up
Authors: Hans Edmund Eckel
Ricard Simo
Miquel Quer
Edward Odell
Vinidh Paleri
Jens Peter Klussmann
Marc Remacle
Elisabeth Sjögren
Cesare Piazza
Publication date: 01-06-2021
Publisher: Springer Berlin Heidelberg
Keywords: Radiotherapy
Laser
Laryngeal Cancer
Laryngeal Cancer
Published in: European Archives of Oto-Rhino-Laryngology / Issue 6/2021
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-06406-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

European Laryngological Society position paper on laryngeal dysplasia Part II: diagnosis, treatment, and follow-up

Abstract

Purpose of review

Summary

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of review

Summary

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