title: Modified type III cordectomy to improve voice outcomes after transoral laser microsurgery for early glottic canser.
abstract: BACKGROUND
  We proposed a modified type III cordectomy for the treatment of early glottic cancer that removed the upper part of the vocalis muscle to improve glottic closure and voice outcomes.
  
  
  METHODS
  Twenty-two patients with early glottic cancer underwent type III cordectomy, including 9 classical (proposed by European Laryngological Society) and 13 modified resections. Multidimensional voice evaluations were performed.
  
  
  RESULTS
  Voice parameters including GRBAS (overall grade [G], roughness of the voice [R], breathiness [B], asthenicity [A], and strain [S]), jitter, shimmer, noise-to-harmonic ratio, maximum phonation time, voice handicap index-functional, physical, and total scores were better in modified resection. Eleven patients (85%) had complete glottic closure in modified resection and 3 (33%) in classical resection (p = .026). Only 2 patients had tumor recurrence, 1 (8%) in the modified resection and 1 (11%) in the classical resection group (p = 1.000).
  
  
  CONCLUSIONS
  Modified type III cordectomy proved to be an oncologically safe method. The voice outcomes were better than those in patients who underwent classical type III cordectomy.
authors: Department of Otolaryngology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan. pychu@vghtpe.gov.tw
authors: Pen-Yuan
authors: PY
authors: Chu
authors: Yen-Bin
authors: YB
authors: Hsu
authors: Tsung-Lun
authors: TL
authors: Lee
authors: Sherry
authors: S
authors: Fu
authors: Li-Mei
authors: LM
authors: Wang
authors: Ya-Chung
authors: YC
authors: Kao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001707:Biopsy, Needle; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014827:Vocal Cords / Q000473:pathology / Q000601:surgery*; D014833:Voice Quality