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Objective To study the clinical application of Fuji intelligent color enhancement ( FICE) on the diagnosis of vocal leukoplakia and esophageal diseases. Methods A total of 50 patients suspected with vocal leukoplakia by electronic laryngoscopy were enrolled for undergoing meticulous examination of vocal cords and esophagus using FICE from January 2014 to January 2016. The diagnostic value of FICE for vocal leukoplakia were analyzed. Results Among the 50 patients, 50 lesions were found using laryngoscopy and 52 lesions were found using FICE. There were significant differences between FICE mode and white light mode on the capillary pattern score and lesion boundary resolution score ( all P<0. 05) . The diagnostic coincidence rate of FICE mode with pathology was higher than that of white light mode [ 89. 4％ ( 42/47 ) VS 68. 1％ ( 32/47 ) , P = 0. 01 ] . Among the 50 patients suspected with vocal leukoplakia, 31 combined with gastroesophageal reflux disease, and were given proton-pump inhibitor treatment. In the follow-up after three months, lesions of 16 cases alleviated, 13 cases disappeared, and 2 cases had no significant changes. Conclusion FICE has a higher clinical value than conventional laryngoscopy and white light endoscopy on the diagnosis of vocal leukoplakia.
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[Abstract ] Objective Clinically, the necessity of acid suppression treatment in vocal leukoplakia is still controversial .This paper aims to investigate the roles of LPR in the pathogenesis and pathological process of vocal leukoplakia , and to clear the signifi-cance of acid suppression in the treatment of this disease through observing the influence of laryngopharyngeal reflux ( LPR) on the symptoms of postoperative vocal leukoplakia . Methods We collected 97 cases underwent vocal leukoplakia surgery from June 2013 to December 2015 in the Department of Otorhinolarygology Head and Neck Surgery , Nanjing General Hospital of Nanjing Military Re-gion.According to the results of ambulatory 24-hour double probe ( simultaneous esophageal and pharyngeal ) pH monitoring ( pH-me-try), the patients with vocal leukoplakia were divided into LPR group (n=26, laryngopharyngeal reflux) and non-LPR group(n=71, non-laryngopharyngeal reflux).Meanwhile, the patients in LPR group were then randomly divided into acid-suppressing group(n=13, oral esomeprazole ) and non-acid-suppressing ( n=13, oral placebo ) . All patients received evaluation and compared by electrolaryngendo-scope, voice handicap index-10 ( VHI-10), reflux symptom index ( RSI) and reflux finding score ( RFS) before operation and 8 weeks after operation, and observe the effect of laryngopharyngeal reflux and acid suppression on the symptoms of postoperative vocal leukoplakia . Results RSI and RFS after operation were significantly lower than before operation in LPR group[(13.6±5.8) vs (18.2±6.2), (9.2±2.4) vs (10.6±2.8), P<0.05].The difference of RSI and RFS between before and after operation in LPR group was higher than the non-LPR group[(5.8±1.4) vs (2.3±0.8), (1.2±0.6) vs (0.5±0.2), P<0.05].The difference of RSI and RFS between before and after operation in acid-suppressing group was higher than the non-acid-suppressing group[(6.6±1.2) vs (0.8±0.6), (2.6±0.6) vs (0.5±0.3), P<0.05].VHI-10 after operation was significantly lower than before operation in acid-suppressing group[(12.6±3.6) vs (15.2±4.2), P<0.05] Conclusion Standard PPI administration to patients suffering from vocal leukoplakia accompanied with LPR can alleviate the symptoms of LPR and improve hoarseness .
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Objective To compare the curative effects between radiofrequency coblation and CO2 Laser in treat-ment of vocal leukoplakia. Methods Clinical data of 29 patients with vocal leukoplakia were retrospectively ana-lyzed. 14 of them were using radiofrequency ablation, the other 15 were using CO2 laser as treatment. Then compare the postoperative pain, postoperative wound healing, the first operation control rate of local recurrence between the two groups. Results Postoperative pain between the two groups has no statistically significance. The mucosal recov-ery of radiofrequency group in 1 month after surgery was better than CO2 laser group. In radiofrequency group, 5 cases suffered recurrence, the recurrence rate was 35.71%; In CO2 laser group, only 1 case suffered recurrence, the recurrence rate was 6.67%. Conclusions Laser and radiofrequency ablation were minimally invasive treatment for vocal cord leukoplakia, while CO2 laser as treatment has lower recurrence rate.
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Objective: To study the diagnostic and therapeutic effects of electronic laryngoscope in treating laryngeal diseases and discuss some problems concerned. Methods: Follow up studies were conducted in 846 patients with laryngeal diseases who were treated electronic laryngoscopically in our department and sex, site of lesion and therapeutic effect were analyzed. Results: The incidence of vocal polyp and nodules in female was significantly higher than that in male, and vise versa in vocal cyst and leukoplakia. Vocal nodules could be located bilaterally, while vocal cyst unilaterally. The operative style applied showed good therapeutic effect. The effective rate for vocal polyp, nodule, and cyst was 99.84%~100%, and that for vocal leukoplakia, 66.67%. Conclusion: Operation under electronic laryngoscope has advantages of rapid performance, small dead angle, high accuracy, few complications, clear image, and little pain, and is beneficial to early diagnosis and treatment of laryngeal diseases. So it is worthy of wide application. [