'How does that sound?': objective and subjective voice outcomes following CO₂ laser resection for early glottic cancer.
OBJECTIVE
To investigate the effect of transoral laser microsurgery for early glottic cancer on subjective and objective vocal outcome measures.


METHODS
Prospective cohort study.


METHODS
Tertiary care cancer centre.


METHODS
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).


METHODS
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.


CONCLUSIONS
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.
Division of Otolaryngology-Head and Neck Surgery, Division of Surgery, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada. shanelester@nhs.net
S E
SE
Lester
M H
MH
Rigby
M
M
MacLean
S M
SM
Taylor
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005931:Glottis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D054020:Lasers, Gas / Q000009:adverse effects*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010699:Phonation / Q000502:physiology; D011446:Prospective Studies; D013068:Speech Production Measurement / Q000379:methods; D013997:Time Factors; D014832:Voice Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014833:Voice Quality / Q000502:physiology