Voice, speech, and swallowing outcomes in laser-treated laryngeal cancer.
OBJECTIVE
To describe preliminary voice, speech, and swallowing outcomes in patients treated by endoscopic laser excision of laryngeal cancer with or without adjuvant radiation therapy.


METHODS
Retrospective review.


METHODS
Seventeen surgically treated patients (five T2 glottic and 12 clinically staged T2 supraglottic squamous cell carcinomas) participated in the study. Self-ratings of voice (Voice Handicap Index) and swallowing (M. D. Anderson Dysphagia Inventory) were completed, as well as independent auditory-perceptual ratings of voice and speech recordings.


RESULTS
Although no significant difference between Voice Handicap Index, M. D. Anderson Dysphagia Inventory, and listener ratings was identified based on tumor site and irradiation status, there was a trend toward poorer outcomes in patients who received adjuvant radiation therapy. Whereas the patients having supraglottic cancer tended to report better voice but poorer swallowing outcomes, the glottic cancer group displayed the opposite pattern. Severity on Voice Handicap Index correlated significantly with listener severity ratings of speech, suggesting that the patients' perception of their voice handicap was similar to the listeners' judgments of their speech severity.


CONCLUSIONS
The results suggest the following trends: 1) Adjuvant radiation therapy was associated with poorer outcomes for voice, speech, and swallowing and may be associated with more impairment than surgery alone and 2) poorer outcomes on voice and swallowing were observed for the glottic and supraglottic cancer groups, respectively. To bolster these preliminary findings, additional outcomes studies in patients treated with conservation therapy are needed.
Jepsen
Matthew C
MC
Division of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Utah, Salt Lake City 84108, USA.
Gurushanthaiah
Deepak
D
Roy
Nelson
N
Smith
Marshall E
ME
Gray
Steven D
SD
Davis
R Kim
RK
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D007828:Laryngoscopy; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000175:diagnosis*; D011832:Radiation Injuries / Q000175:diagnosis; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012307:Risk Factors; D013064:Speech Disorders / Q000175:diagnosis*; D016896:Treatment Outcome; D014832:Voice Disorders / Q000175:diagnosis*