For the reason, follow up with stroboscopy for layryngeal leukoplakia is highly recommended. Hyperkeratosis is a thickened buildup of the squamous epithelial tissue covering of the vocal fold. This mass is a reaction of the tissue to airborne pollutants, particularly cigarette smoking. Like the name implies, excessive production of keratin on the top layer of squamous epithelium is probably a defense mechanism of the tissue, stimulated by irritation. A large area is often seen in the posterior commissure in reaction to gastroesophogeal reflux.
Biopsy can reveal anything from benign hyperkeratosis to severe cellular atypia.
Changes in color or ulceration in a hyperkeratosis lesion indicates a need for biopsy of that area.