Comparative voice results after laser resection or irradiation of T1 vocal cord carcinoma.
OBJECTIVE
To compare voice results following laser resection or radiation therapy for T1a glottic carcinomas.


METHODS
Objective recordings of acoustical data that were analyzed and calculated by an acoustic analyzer and subjective scores by patients, speech therapists, surgeons, and radiation therapists are compared.


METHODS
Academic medical center speech laboratory at an institution where patients had been treated. Archival files were searched and patients were solicited by letter to participate in this analysis.


METHODS
Men treated at least 6 months previously and who were without active laryngeal disease. Criteria were unilateral vocal cord carcinomatous involvement with no subglottic, anterior commissure, or arytenoid extension and tumor invasion clinically judged to be less than half of the cordal depth.


METHODS
Thirteen patients had received approximately 63 Gy in 28 fractions, five fractions a week, with laterally opposed fields using a linear accelerator. Eleven patients had had resection of less than half of the cordal depth by using a carbon dioxide laser with a 300-microns spot size working at a 400-mm distance; 13- to 15-W power intensity with a one tenth of a second burn in a noncontinuous mode.


RESULTS
No statistically significant differences between the two study groups were found. Patients and physicians subjectively rated (1 indicates normal; 5, aphonic) the quality of voices of patients in the irradiation group (1.5 and 2.0) as slightly better than the quality of voices of patients in the laser group (2.0 and 2.4). Speech pathologists rated the voices of patients in the laser and irradiation group as indistinguishable and mildly abnormal (2.75 and 2.73).


CONCLUSIONS
Voice quality in highly selected patients with vocal cord carcinoma treated by laser resection can be as good as that in patients whose cancer was similarly staged after radiation therapy.
McGuirt
W F
WF
Department of Otolaryngology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC.
Blalock
D
D
Koufman
J A
JA
Feehs
R S
RS
Hilliard
A J
AJ
Greven
K
K
Randall
M
M
D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D053685:Laser Therapy; D008297:Male; D009367:Neoplasm Staging; D013061:Speech Acoustics; D014827:Vocal Cords / Q000601:surgery; D014833:Voice Quality