抄録
A clinicohistological study of 34 cases of hyperkeratosis the authors treated was presented. This precancerous condition has traditionally been diversely called hyperkeratosis, keratosis, leukoplakia, pachydermia and keratotic papilloma.
1. Of the 34 cases of hyperkeratosis of the larynx, males numbered 28 and females 6, showing male predominance. It was mainly seen in the fourth to sixth decades.
2. Hoarseness was seen in 33 patients as a chief complaint.
3. Smoking, excessive use of the voice and industrial pollution seemed to play some role as inducing factors.
4. Lesions were seen in the anterior third of the vocal cord in many cases, although diffuse involvement along the entire length of the vocal cord or bilateral involvement was also observed.
5. The 34 cases were classified according to indirect laryngoscopic findings into hyperkeratosis (11), leukoplakia (16), pachydermia (1) and keratotic papilloma (6).
6. Histologically, they were simple hyperkeratosis (10), hyperkeratosis with localized atypia (11) and hyperkeratosis with carcinoma in situ (13).
7. The methods of therapy employed were resection under an indirect laryngoscope (12), laryngofissure (2) and resection under a laryngomicroscope (20). Postoperative irradiation was performed on five patients. Of these, resection under a laryngomicroscope was the safest and surest method. The author is of the impression that for hyperkeratosis with atypical epithelium postoperative irradiation is necessary.
8. After treatment 10 of the 34 saw recurrence, indicating that this lesion is rather prone to recurrence. There were four patients whose lesions underwent malignant transformation, for which cordectomy, partial laryngectomy or total laryngectomy was performed. One patient died of an ailment other than the original lesion and all the rest are living at present.
