Leukoplakia of the vocal folds is commonly found in association with hoarseness in smokers Direct laryngoscopy with biopsy is advised in almost all cases Histologic examination usually demonstrates mild, moderate, or severe dysplasia In some cases, invasive squamous cell carcinoma is present in the initial biopsy specimen Cessation of smoking may reverse or stabilize mild or moderate dysplasia Some patients—estimated to be less than 5% of those with mild dysplasia and about 35–60% of those with severe dysplasia—will subsequently develop squamous cell carcinoma

Treatment

options include proton-pump inhibitor therapy, close follow-up with laryngovideostroboscopy, serial resection, and external beam radiation therapy