VOCAL CORD CANCER, DYSPASIA, AND LEUKOPLAKIA

The vocal cords are unable to be seen by looking in the back of your throat. Suspicious lesions can be identified on videostroboscopy in our office. Definitive diagnosis of a vocal cord cancer requires a biopsy with analysis of the tissue underneath a microscope by a pathologist. If you choose to pursue laser surgery, a biopsy and removal of the cancer can be performed at the same time to prevent the need for multiple surgeries.

Patients who are healthy enough to tolerate a general anesthesia procedure and have an early vocal cord cancer (T1 or T2) or precancers/dysplasia of the true or false vocal folds. This includes lesions such as leukoplakia, erythroplakia, or keratosis that affects the quality of your voice. 

We will be able to tell you the day of consultation if you are a good candidate for this procedure.

All cancer surgery involves general anesthesia. The procedures are performed completely endoscopically, meaning there are no incisions or cuts on the outside of your neck. A metal laryngoscope is placed through the mouth to allow visualization of the vocal cords. If a biopsy has not already been performed, it will be performed at the time of this surgery. Frozen pathology will confirm diagnosis and clear margins. The entire procedure is performed with the use of a microscope to obtain ultra-narrow margins and preserve normal vocal cord tissue.  Depending on how extensive the cancer is, a patient may require staged surgery with the 2nd procedure occurring six to eight weeks after the first one to completely remove all of the cancer.

The surgery is outpatient. Patients can expect to eat and speak right after the procedure. Your voice may be more hoarse immediately following the procedure as the surgical wound heals, but will improve over the following weeks. It is not uncommon to have a sore throat or tongue following the procedure, due to placement of the laryngoscope. Dr. Burckardt may ask you to avoid “reflux” foods (no greasy, spicy, citrus, or caffeine) while the wound is healing. There is little down time from the procedure. Depending on your job, you may be able to return to work the same week as surgery. 

After the procedure, patients will be followed closely at 4-6 week intervals for one year to make sure the vocal cords are healing appropriately and no new cancers arise. After the first year, patients will still need to be seen for surveillance but the follow-up interval will gradually increase.

​If you have ever been diagnosed with head and neck cancer, you should have lifelong surveillance with an Otolaryngologist to ensure a second tumor does not develop.

Complications from laser surgery are uncommon. The biggest risk of the procedure is the risk of undergoing general anesthesia. Complications from the laryngoscopy include:

• Temporary sore throat
• Chipped, damaged, or broken teeth. Dr. Burckardt uses tooth guards to prevent this complication.
• Superficial cuts inside the mouth or throat.
• Temporary changes in taste or numbness of the tongue
• Granuloma formation