Difficulties in management of vocal cord precancerous lesions.

Hyperplastic aberrations are differently classified and the term of precancerosis diversely interpreted; therefore, it is extremely difficult to evaluate the effectiveness of particular therapeutic methods. A standardized classication would enable an objective assessment of the treatment for precanceroses. Our own conception of the histologic patterns in precanceroses is presented. In the period 1960-1975, a total of 2,700 biopsies were performed in patients with hyperplastic aberrations in the vocal cord mucosa. In 133 patients, histology revealed precancerosis. In the patients who had received medical therapy, no improvement was obtained; on the contrary, in 16 patients the process became malignant. Among the patients who had undergone de-epithelialization (61), 44 were cured. After the de-epithelialization, no precancerous case turned malignant. De-epithelialization has been shown to be the procedure of choice for the treatment of precanceroses of the vocal cord.