Laryngeal Melanosis

Abstract

Objective Laryngeal melanosis (LM) is an unusual condition. Little is known about its clinical significance. To learn more about this unusual disorder, we prospectively gathered data on a series of patients with LM and compared the data with the summarized findings from the cases currently available in the literature. Study Design Case series with planned data collection. Setting Two hundred fifty-five–bed urban indigent care hospital located on a university medical center campus. Subjects and Methods Demographics, history, examination findings, and concurrent head and neck disorders were prospectively recorded for all patients with LM who presented to our institution between 2005 and 2012. Results Eighteen patients with laryngeal melanosis were enrolled. All patients are African American, and all have a history of chronic tobacco use. The most common presenting symptom was dysphonia, and examination most often revealed flat, pigmented lesions of the larynx. Nine patients (50%) had concomitant squamous cell carcinoma of the upper aerodigestive tract. There are 19 previous cases of laryngeal melanosis reported by 12 different authors, with a concomitant carcinoma rate of 26%. Our patients are similar in age and are all African American, with a greater percentage of women and greater rate of concomitant carcinoma. Our study represents the single largest case series of laryngeal melanosis and is more complete given the prospective nature of the data collection. Conclusion Laryngeal melanosis is an unusual disorder that is associated with chronic tobacco use. Clinicians should be aware of the association between laryngeal melanosis and squamous cell carcinoma and perform a thorough evaluation for concomitant carcinoma.