The Diagnostic Efficacy of Flexible Fiberoptic Laryngoscopy and Its Correlation With Histopathology in Different Benign Lesions of the Vocal Cord in a Tertiary Care Hospital: A Prospective Clinical Study

Introduction Benign vocal cord lesions are diagnosed by clinical examination with usually an office-based laryngoscopy examination. The severity of voice impairment can be assessed by severity scores such as the Voice Handicap Index (VHI). These lesions are usually treated by conservative methods such as voice rest/restriction and voice therapy. A clinically benign-looking lesion does not always exclude the presence of malignancy. A mere clinical diagnosis of a benign vocal cord lesion is not complete, and hence, a confirmed diagnosis is made only after excision and histopathological examination (HPE) of the lesion. Aim This study was primarily aimed at knowing the prevalence, etiological factors, and clinical presentation of patients with benign vocal cord lesions, assessing the diagnostic potential of flexible fiberoptic laryngoscopy (FFL) in different benign lesions of the vocal cord and its correlation with histopathology, and studying the symptomatology and severity of symptoms in different benign vocal cord lesions using the Vocal Handicap Index-10. Method A prospective study of benign lesions of the vocal cord was conducted from January 2018 to June 2019 on 125 cases in a tertiary care hospital. All the benign lesions were clinically diagnosed with flexible fiberoptic laryngoscopy, and their findings were correlated with histopathology examination. Results Of the 125 patients, the overall prevalence of benign vocal cord lesions was higher in male patients (n = 88 (70.4%)) than in female patients (n = 37 (29.6%)). Voice abuse is the major risk factor for benign vocal cord lesions. The most common lesion identified by flexible fiberoptic laryngoscopic (FFL) examination is polyps (61%), followed by nodules (14%) and keratosis (13%). On the correlation of clinical diagnosis with histopathological examination, the diagnostic accuracy of FFL is 51.8% for nodules, 44.4% for polyps, 35.5% for keratosis, and 75% for granulomas. The diagnostic accuracy of FFL examination in diagnosing truly benign lesions is 94.9%. Conclusion Benign vocal cord lesions are one of the common cases seen in ENT practice. Voice abuse was the predominant causative factor for all these lesions. In our study, vocal polyp was the most common lesion by clinical examination using FFL. On correlation of fiberoptic laryngoscopic diagnosis with histopathological examination, the diagnostic accuracy of FFL examination in diagnosing truly benign lesions is 94.9% in our study.