Precancerous Vocal Cord Dysplasia Program

About This Program

The Massachusetts General Hospital Center for Laryngeal Surgery and Voice Rehabilitation (Voice Center) team has established the standard of care for the treatment of vocal cord dysplasia. For the past 15 years, our team has refined and perfected the treatment, which is described in a group of publications. We have been invited to share and teach these innovative techniques throughout the United States and around the world. Based on this body of work, the Voice Center is recognized nationally and internationally for their highly successful pioneering surgical techniques to restore and preserve the voice of patients with vocal cord dysplasia.

About the Condition

The membranes of the vocal cords can develop precancerous surface changes known as dysplasia or atypia. In this stage, they do not yet have cancer; however, if left untreated, these involved areas can progress to become cancerous. Other terms associated with this precancerous change of the vocal cords include:

• Erythroplasia, erythroplakia - red patch
• Keratosis - skin-like thickening of the surface
• Leukoplakia - white patch

The majority of patients with dysplasia have smoked at some time in their life, although it may have been many years prior to the development of vocal cord dysplasia. A smaller group of non-smokers may develop dysplasia, which may be caused by a virus.

Potassium Titanyl Phosphate (KTP) Laser

When patients develop precancerous dysplasia of the vocal cords, there is a window of opportunity to treat the disease before it deteriorates to cancer. The goal is to carefully remove the diseased membranes of the vocal cord while preserving or restoring voice. Initially, the patient is scheduled to go to the operating room to examine the larynx with a surgical microscope (microlaryngoscopy) under general anesthesia. This minimally invasive operation is performed exclusively through the mouth. During the procedure, the dysplasia is typically biopsied and also treated using the pulsed-potassium-titanyl-phostphate (KTP) laser. The patient usually leaves the hospital later that day, several hours after the procedure.

Office-based Laser Treatment

It is commonplace for vocal cord membranes to re-develop dysplasia after they have been successfully treated, similar to someone who has sun-damaged skin. The Mass General Voice Center team can treat recurrent vocal dysplasia after it has been initially diagnosed and treated in the operating room with an office-based procedure, which does not require general anesthesia and lasts approximately 20 minutes.

In fact, office-based laryngeal laser surgery⁠—for both vocal cord dysplasia and laryngeal recurrent respiratory papillomatosis, or RRP⁠—was originally created by members of the Mass General Voice Center team.

We strongly disagree with the philosophy of many physicians who simply observe the vocal cord dysplasia until it degenerates into cancer. We believe that watchful waiting of vocal cord dysplasia allows for unchecked degeneration of a precancerous lesion to become cancer. Our surgeons will design a treatment program tailored to the needs of the individual patient.