09-10, 08:00–08:30 (Europe/Istanbul), Phoniatrics 3
Background and Rationale:
High-definition white light endoscopy (WLE) remains the standard-of-care for evaluating early laryngeal lesions, providing high-resolution surface and color information. However, WLE has well-recognized limitations. Early dysplasia may lack clear surface changes, while benign inflammatory lesions can mimic malignancy, resulting in sensitivity values as low as 51% in some studies.
The quintessential clinical dilemma is vocal fold leukoplakia—a descriptive term encompassing a wide histopathological spectrum, from benign hyperkeratosis to invasive squamous cell carcinoma (Piazza et al., 2010). Because WLE cannot reliably predict histopathological severity, management remains highly controversial. Some clinicians advocate routine surgical biopsy due to the risk of occult carcinoma, while others support conservative observation in low-risk cases (Peretti et al., 2017). This uncertainty results in a significant healthcare burden driven by repeated surveillance, unnecessary biopsies, and the risk of delayed diagnosis.
Role of Narrow Band Imaging (NBI):
NBI has emerged as a critical adjunct by enhancing the visualization of intraepithelial papillary capillary loops (IPCLs), thereby improving the detection of neoplastic vascular patterns (Piazza and Peretti, 2012). Recent literature demonstrates a strong correlation between NBI vascular patterns and histopathological outcomes, improving diagnostic precision and aiding in the prediction of malignant transformation in leukoplakia (Lin et al., 2020; Pietruszewska et al., 2021).
Despite its growing acceptance, NBI is not a panacea. It remains highly dependent on operator expertise and is subject to diagnostic pitfalls, particularly in post-radiotherapy mucosa and lesions with deep submucosal extension.
Aim of the Session:
This interactive round table will critically evaluate the real-world utility of NBI in detecting premalignant and malignant laryngeal lesions. By assembling a multidisciplinary panel of experts, the session will bridge the gap between theoretical diagnostic accuracy and daily clinical decision-making in vocal fold leukoplakia.
Expected Outcomes:
Practical, consensus-based guidance on when NBI should and should not dictate biopsy decisions in leukoplakia.
A clear understanding of NBI pitfalls in post-radiotherapy surveillance.
A roadmap for the integration of AI and next-generation endoscopic modalities into laryngology.
Professor Hazem Mohamed Aly Saleh, MD, PhD, MSc, DEA, is Professor of Otolaryngology–Head and Neck Surgery at Cairo University. He received his specialist training in France more than two decades ago, building a distinguished academic and surgical career bridging the European and Egyptian medical systems.
He earned his Medical Doctorate (MD) in Otolaryngology–Head and Neck Surgery from Université Clermont-Ferrand. His advanced qualifications include a Diploma in Laser Surgery and a Diplôme d’Études Approfondies (DEA) in Neuroscience from Université de Montpellier, as well as a Diploma in Head and Neck Oncologic Surgery from Institut Gustave Roussy. He also holds a Master of Science in Otolaryngology from Cairo University and a French Master of Medical and Biological Sciences. In recognition of his academic merit, he was awarded the prestigious title of “Maître en Otorhinolaryngologie” by the French government.
Professor Saleh is an active member of leading international professional bodies, including the American Head and Neck Society, the French and Egyptian Societies of Otolaryngology–Head and Neck Surgery, the International Association of Phonosurgery, and the Union of European Phoniatricians.
His clinical expertise focuses on conservative laryngeal surgery, transoral laser microsurgery, and phonosurgery. Over a career spanning more than thirty years, he has authored and co-authored over 20 peer-reviewed publications and contributed to two internationally recognized textbooks: Complications of Head and Neck Surgery, edited by David Eisele, and Magnetic Nanoparticles, edited by Nguyen Thanh.
A frequent invited speaker, moderator, and chairperson at national, regional, and international conferences, Professor Saleh has also organized and chaired international meetings and specialized workshops on Laser in Laryngology in Egypt and across the Arab Gulf region. He further served as Organizer and Academic Supervisor of an intensive preparatory program at the French Center for Culture and Cooperation in Cairo, preparing Egyptian medical graduates for the French national residency examination (“Internat”).
