Voice quality after CO2 laser cordectomy--what can we really expect?
BACKGROUND
Endoscopic management of laryngeal carcinoma has gained popularity among laryngologists based on the good oncologic and functional results. We evaluated the voice quality after laser cordectomy for early glottic cancer in a variety of vocal situations and its relation with the extension of resection and the age.


METHODS
We conducted a cross-sectional study of voice quality in 42 consecutive male patients treated for T1 glottic carcinoma with laser cordectomy. Patients were compared with 21 controls. Voice quality was self-assessed by the patients. Perceptual analysis was done by a speech pathologist on a running speech sample [GRBAS (grade, roughness, breathiness, asthenicity, strain)]. Acoustic analysis included fundamental frequency (F0), jitter, shimmer, noise to harmonic ratio (N/H), and maximum phonation time (MPT) on the sustained vowels /a/ and /i/, and on various running speech voice samples.


RESULTS
Distribution of the patients included in the study by T classification was as follows: Tis, n = 2 (4.8%); T1a, n = 35 (83.3%); and T1b, n = 5 (11.9%). Cordectomy types were: (I), 14%; (II), 26%; (III), 21%; and (V), 38%. Voice improved in almost 60% of patients, returning to normal in 45%. GRBAS showed significant differences between patients and controls and correlated with type of cordectomy. Acoustic analysis showed significant differences in F0, and jitter, with smaller differences in shimmer, N/H, and MPT.


CONCLUSIONS
Voice quality after laser cordectomy differs from controls, but improves in a majority of patients after the surgery, with almost 50% of patients with subjective normal or near normal voice. Voice quality depends on type of cordectomy.
Vilaseca
Isabel
I
Otolaryngology Department, Hospital Clínic Universitari, Barcelona, Spain. ivila@clinic.ub.es
Huerta
Paula
P
Blanch
José Luis
JL
Fernández-Planas
Ana María
AM
Jiménez
Conchita
C
Bernal-Sprekelsen
Manuel
M
D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide; D002277:Carcinoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005931:Glottis / Q000473:pathology / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D053685:Laser Therapy / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014827:Vocal Cords / Q000601:surgery*; D014832:Voice Disorders / Q000209:etiology / Q000601:surgery; D014833:Voice Quality
D002245:Carbon Dioxide