Evaluation of vascular features of vocal cords proposed by the European Laryngological Society

Robert Šifrer, Johannes A. Rijken, C. René Leemans, Simone E. J. Eerenstein, Stijn van Weert, Jan-Jaap Hendrickx, Elisabeth Bloemena, Derrek A. Heuveling, Rico N. P. M. Rinkel

Research output: Contribution to journalArticleAcademicpeer-review

29 Citations (Scopus)


A newly proposed classification by the European Laryngological Society (ELS) of glottic lesions by narrow-band imaging (NBI) divides their vascular patterns into longitudinal and perpendicular ones. The latter are further subdivided into the wide and narrow patterns. The longitudinal, wide, and narrow patterns are characteristic of benign disease, papilloma, and malignancy, respectively. The aim of the study was to investigate the diagnostic effectiveness of the classification. Forty patients with glottic lesions underwent microlaryngoscopy. The vascular patterns of all vocal cords were defined with NBI. The affected vocal cords were histologically analysed and comprised the arm (A). Unaffected vocal cords were not histologically analysed but followed-up and comprised the arm (B) and were regarded as true negatives if no suspicious changes appeared during the follow-up. The vocal cords from the arm A were categorised into the benign and malignant group according to the histologic result. The ratio of vascular patterns was determined and the groups were statistically compared using the Chi-square test and Fisher’s exact test. Perpendicular changes were observed in 36.6% (9/26) of benign diseases and in 100% (23/23) of cancer conditions (p OpenSPiltSPi 0.001). Wide perpendicular changes appeared only in papillomas (6/6) while narrow ones mostly in malignancies (23/26) and also in benign conditions (3/26) (p OpenSPiltSPi 0.001). The sensitivity, specificity, positive and negative predictive values, and accuracy were 100, 95, 88, 100 and 96%, respectively. The new ELS classification can be used effectively and safely to differentiate malignant from benign disease.
Original languageEnglish
Pages (from-to)147-151
Number of pages5
JournalEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS)
Issue number1
Publication statusPublished - 1 Jan 2018


  • Cancer
  • Glottis
  • Longitudinal vascular patterns
  • Narrow-band imaging
  • Perpendicular vascular patterns

Cite this