Benign vocal fold lesions: a diagnostic challenge
Patrick J.P. Poels, Felix I.C.R.S. de Jong, Harm K Schutte
The purpose of this retrospective study was to assess the preoperative and intraoperative diagnosis of benign vocal fold lesions for consistency. Consecutively, the diagnosis was established in 221 patients with benign vocal fold lesions for which a microlaryngoscopical intervention was carried out in a general ENT-clinic. Preoperatively, the vocal folds were examined with both white halogen and stroboscopic light. The diagnosis at the intervention was obtained by direct microscopical visualisation and palpation of the vocal folds with micro-instruments. In 36% of the patients the preoperative diagnosis differed from the diagnosis at the intervention. In 31% of the patients a lesion was not observed at the preoperative examination but was observed only during microlaryngoscopy. Bilateral lesions were found in 53% of the patients preoperatively and in 82% of the patients at the intervention. Especially intracordal lesions constituted a diagnostic pitfall. Because the preoperative and intraoperative diagnosis frequently differed, both the patients and the ENT-surgeon must keep an open mind about what may be necessarily done at the time of intervention.
Patrick JP Poels, MD1, Felix ICRS de Jong, MD, PhD1,2, Harm K Schutte, MD, PhD3
1 Bernhoven Hospital, Veghel, The Netherlands*
2 Department of ENT/Voice and Speech Pathology University Medical Centre, St. Radboud Nijmegen, The Netherlands
3 GroningenVoice Research Lab. Department of Biomedical Engineering, University of Groningen, The Netherlands