Patient: 59-year-old female

Reason for Consultation/Symptoms: Intermittent dysphonia for approximately 1 year, characterized by hoarseness, vocal fatigue, and throat clearing. No dyspnea or dysphagia.

Medical History and Lifestyle:

- Comorbidities: grade A esophagitis, ulcerative colitis, Hashimoto's thyroiditis, anxiety disorder, and hypercholesterolemia.

- Allergies: known allergy to amoxicillin.

- Lifestyle: former smoker; quit 15 years ago (5 pack-years; 5 cigarettes/day for 20 years). No alcohol consumption.

Voice Assessment (GIRBAS): GIRBAS score: G2, I2, R2, B0, A1, S0 (moderate dysphonia with marked instability and roughness, and mild asthenia).

Laryngeal Endoscopy (FLS - White Light): Raised leukoplakic lesion with a verrucous appearance involving the anterior third of the left vocal fold. Bilaterally preserved vocal fold mobility and adequate airway patency. No abnormalities of the pyriform sinuses.

Laryngeal Endoscopy (FLS - NBI): Type III vascular pattern (Ni classification).

Surgical Indication: CO2 laser transoral microsurgery under general anesthesia.