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‘How does that sound?’: objective and subjective voice outcomes following CO2 laser resection for early glottic cancer

Published online by Cambridge University Press:  03 October 2011

S E Lester*
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Division of Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
M H Rigby
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Division of Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
M MacLean
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Division of Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
S M Taylor
Affiliation:
Division of Otolaryngology-Head and Neck Surgery, Division of Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
*
Address for correspondence: Mr Shane Lester, Consultant ENT Surgeon, Darlington Memorial Hospital, Darlington, Durham, DL3 6HX E-mail: shanelester@nhs.net

Abstract

Objective:

To investigate the effect of transoral laser microsurgery for early glottic cancer on subjective and objective vocal outcome measures.

Design:

Prospective cohort study.

Setting:

Tertiary care cancer centre.

Participants:

All patients scheduled for transoral laser microsurgery for untreated early primary glottic cancer over a 22-month period and offered voice assessment (31 patients; 19 tumour stage one, 12 tumour stage two).

Main outcome measures:

Fundamental frequency, maximum phonation time, calculated jitter, shimmer and subjective voice rating, analysed by tumour stage.

Results:

Tumour stage T1 patients had significantly different fundamental frequencies and maximum phonation times at three months post-operatively, compared with pre-operative values; these differences resolved by 12 months. At 12 months, tumour stage T2 patients had significantly shorter maximum phonation times, and all patients reported significantly worse subjective voice ratings, compared with pre-operative values.

Conclusion:

We found no change in fundamental frequency, jitter and shimmer, one year post-operatively. Maximum phonation time deteriorated but stage one patients appeared to compensate, whereas stage two patients did not. Resection size may be a factor. All patients reported significantly worse subjective voice ratings at one year. Aerodynamic and subjective voice measures appear most sensitive to change in this patient group.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Zeitels, SM, Hillman, RE, Franco, RA, Bunting, GW. Voice and treatment outcome from phonosurgical management of early glottic cancer. Ann Otol Rhinol Laryngol Suppl 2002;190:320Google Scholar
2Peretti, G, Piazza, C, Balzanelli, C, Mensi, MC, Rossini, M, Antonelli, AR. Preoperative and postoperative voice in Tis-Tl glottic cancer treated by endoscopic cordectomy: an additional issue for patient counseling. Ann Otol Rhinol Laryngol 2003;112:759–63Google Scholar
3Van Gogh, CD, Mahieu, HF, Kuik, DJ, Rinkel, RN, Langendijk, JA, Verdonck-de Leeuw, IM. Voice in early glottic cancer compared to benign voice pathology. Eur Arch Otorhinolaryngol 2007;264:1033–8Google Scholar
4Tamura, E, Itahara, S, Ogura, M, Kohno, N. Voice quality after laser surgery or radiotherapy for T1a glottic carcinoma. Laryngoscope 2003;113:910–14Google Scholar
5Jong-Lyel, R, Dong-Hyun, K, Sang Yoon, K, II Park, C. Quality of life and voice in patients after laser cordectomy for Tis and T1 glottic carcinomas. Head Neck 2007;29:1010–16Google Scholar
6Sjögren, EV, van Rossum, MA, Langeveld, TP, Voerman, MS, van de Kamp, VA, Friebel, MO et al. Voice outcome in T1a midcord glottic carcinoma laser surgery vs radiotherapy. Arch Otolaryngol Head Neck Surg 2008;134:965–72CrossRefGoogle ScholarPubMed
7Rosier, JF, Grégoire, V, Counoy, H, Octave-Prignot, M, Rombaut, P, Scalliet, P et al. Comparison of external radiotherapy, laser microsurgery and partial laryngectomy for the treatment of T1N0M0 glottic carcinomas: a retrospective evaluation. Radiother Oncol 1998;48:175–83Google Scholar
8Vilaseca, I, Huerta, P, Blanch, JL, Fernandez-Planas, AM, Jimeinez, C, Bernal-Sprekelsen, M. Voice quality after CO2 laser cordectomy — what can we really expect? Head Neck 2008;30:43–9Google Scholar
9Cohen, SM, Garrett, CG, Dupont, WD, Ossoff, RH, Courey, MS. Voice-related quality of life in T1 glottic cancer: irradiation versus endoscopic excision. Ann Otol Rhinol Laryngol 2006;115:581–6CrossRefGoogle ScholarPubMed
10Dejonckere, PH, Bradley, P, Clemente, P, Cornut, G, Crevier-Buchman, L, Friedrich, G et al. Committee on Phoniatrics of the European Laryngological Society (ELS). A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques: guideline elaborated by the Committee on Phoniatrics of the European Laryngological Society (ELS). Eur Arch Otorhinolaryngol 2001;258:7782Google Scholar
11Núñez Batalla, F, Caminero Cueva, MJ, Señaris González, B, Llorente Pendás, JL, Gorriz Gil, C, López, Llames A et al. Voice quality after endoscopic laser surgery and radiotherapy for early glottic cancer: objective measurements emphasizing the Voice Handicap Index. Eur Arch Otorhinolaryngol 2008;265:543–8Google Scholar
12van Gogh, CD, Verdonck-de Leeuw, IM, Boon-Kamma, BA, Rinkel, RN, de Bruin, MD, Langendijk, JA et al. The efficacy of voice therapy in patients after treatment for early glottic carcinoma. Cancer 2006;106:95105Google Scholar
13Jacobson, BH, Johnson, A, Grywalski, C, Silbergleit, A, Jacobson, G, Benninger, MS. The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol 1997;6:6670Google Scholar