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Ten years prior to our evaluation, a 73-year-old woman had had a lesion removed from her vocal fold; the lesion had been histologically diagnosed as a laryngeal papilloma. She experienced no further problems during the intervening years until she began to become progressively hoarse 3 months prior to presentation.

Examination under anesthesia with a 0[degrees] endoscope detected white sessile lesions on the right vocal fold and some areas of polypoid change (figure, A). An area of reactive traumatic mucosal thickening was seen on the lower lip of the left vocal fold. Examination with a 70[degrees] endoscope delineated the extent of the lesion and ...