Leukoplakia and Keratosis have been successfully treated by Direct Voice Rehabilitation (DVR) dating back to my peer-reviewed printout in my textbook Modern Techniques of Vocal Rehabilitation in 1973.

Dr. Morton Cooper reports outstanding results with Leukoplakia and Keratosis by Direct Voice Rehabilitation (DVR). Dr. Cooper’s success and cures of this condition was detailed in his textbook Modern Techniques of Vocal Rehabilitation in 1973. From that time on Dr. Cooper reports faster results because of discoveries he has made with locating the right pitch of voice, the right placement of voice, the better way to breathe right for speaking, and focus in on the voice image and voice identity which he finds are all key to successful voice rehabilitation.

Dr. Cooper served on the staff and faculty of the UCLA Medical Center from 1961 to 1969. Dr. Cooper ran the Voice and Speech Clinic for the medical center. His Chairman of the Head and Neck Division wrote: “Dr. Cooper is the best speech pathologist I know.” Dr. Cooper has been in the field of voice rehabilitation specializing in voice care for all types of voice problems for forty-five years.

Leukoplakia and keratosis of the vocal folds are premalignant lesions. The etiology remains unknown, but factors which contribute to their onset and development include smoking and voice misuse and abuse. They have competed with environmental noise during their work and/or recreational activities. The cessation of smoking when the individual is a smoker, and/or the elimination of voice misuse and abuse when such prevails has resulted in a reduction or elimination of the lesions. Patients with these conditions who are nonsmokers and who change their voice patterns experience a disappearance of the growth (s). Individuals who smoke and who desist from smoking when the condition is made known to them also report a reduction or disappearance of the growth (s). Smoking, as has been indicated elsewhere, has a tendency to drop the pitch of the voice to a pitch level which is too low for the individual and therefore creates laryngeal and pharyngeal tensions for the individual.

Surgery has been the main approach in the past. Voice rehabilitation has not been the usual procedure prior to or following surgery. Some patients seen who have undergone surgical treatment for the removal of these lesions have experienced a return of the growths. As with benign growths, such as nodes, polyps, and contact ulcers, voice rehabilitation alone or in conjunction with surgery should be considered for leukoplakia and keratosis. Brodnitz (1963) recommends voice rehabilitation as being helpful for leukoplakia. Peacher (1963) describes voice therapy as aiding keratosis and leukoplakia by voice therapy. Cracovaner (1965) writes that leukoplakia and hyperkeratotic lesions may be reversed by eliminating causal factors, such as smoking, alcohol, voice abuse, and chronic infection. What applies to the benign lesions of the vocal folds is even more applicable to the premalignant lesions; the laryngologist uses his discretion as to what procedures will most benefit the patient not only to reduce and eliminate the growth but also to provide information and guidelines which can to some extent remove and eliminate irritants that may be contributing to the condition itself.

Therapy for leukoplakia and keratosis of the vocal folds parallels that of voice therapy for the benign organic lesions of the folds. Although individuals with leukoplakia and keratosis are usually using a pitch level which is below the optimal pitch, they are not necessarily using a basal or near basal pitch level. The optimal pitch level and range must be located and established at the same time that the balanced oral and nasal resonance is mastered. A voice image almost invariably exists in these patients.

Of the 17 patients seen with leukoplakia, the following conclusions may be drawn regarding leukoplakia:

1. Of the 17 patients seen, 9 or 52.9 percent entered therapy.
2. Of the 9 patients entering therapy, 8 or 88.9 percent completed therapy.
3. Of the 8 patients completing therapy, 3 or 37.5 percent had long-term therapy and 5 or 62.5 percent had short-term therapy.
4. Of the 8 patients completing therapy, the results were excellent, 4 or 50 percent; fair, 4 or 50 percent.
5. The comparison between males and females seen: males, 14 or 82.4 percent; females, 3 or 17.6 percent.

Of the 6 patients seen with keratosis, the following conclusions may be drawn regarding keratosis:

1. Of the 6 patients seen, 5 or 83.3 percent entered therapy.
2. Of the 5 patients entering therapy, 4 or 80 percent completed therapy.
3. Of the 4 patients completing therapy, 2 or 50 percent had long-term therapy and 2 or 50 percent had short-term therapy.
4. Of the 4 patients completing therapy, the results were excellent, 2 or 50 percent; good, 1 or 25 percent; fair, 1 or 25 percent.
5. The comparison between males and females seen: males, 4 or 66.7 percent; females, 2 or 33.3 percent.