[Precancerous diseases and the early recognition of pharyngeal and laryngeal carcinomas].

Precursors and early symptoms of pharyngeal cancers generally appear without specificity. Mostly they are recognized in the stage of progressive carcinoma, so requiring a more radical therapy. Another situation you will find in laryngeal tumours. The early detection of laryngeal cancers has been mainly influenced by the favourable experiences of gynecologists with portio precancerous diseases. So an essential contribution to early detection of laryngeal cancer was given here by using a system of graduated methods regarding precursors and early stages of laryngeal carcinoma supplied by critical evaluation of early symptoms (hoarseness, disturbances of swallowing). The principle of clinical diagnostics turns out to be an exact observation of laryngeal mucosa surface by means of microscope, occasionally supported and extended by means of further investigations, e.g. exfoliative cytology and supravital staining. Moreover, for instance laryngostroboscopy permits to record vocal folds' movements so enabling a careful registration of laryngeal function. Nevertheless therapy of precancerous epithelial lesions in the larynx can be determined by histology only. Thereto we could demonstrate by means of evaluation of numerous patients' data as by scanning electron microscopic investigations of the laryngeal mucosa, that the rate of malignant transformation of localized (leukoplasia, pachyderma, keratosis) and diffuse epithelial lesions (chronic laryngitis) obviously seems to be greater in cases of verrucous or papillary surface structure of mucosa than in plain one. Finally, general recommendations for diagnostics and therapy of epithelial dysplasias and carcinoma in situ of the larynx according to the ORL society of the GDR are presented now.