title: Voice outcomes following laser cordectomy for early glottic cancer: a physical model investigation.
abstract: OBJECTIVE
  The voice effects following laser cordectomy for early glottic cancer are poorly described. We investigated the voice outcomes of subligamentous cordectomy of progressive anterior-posterior extent of excision.
  
  
  METHODS
  Physical phonatory modeling.
  
  
  METHODS
  The influence of vocal fold surgical defects and corresponding scar was experimentally investigated using a self-oscillating physical model of the vocal folds and compared with the baseline model without defects or scar.
  
  
  RESULTS
  Results showed that increasing anterior-posterior extent of resection increased phonation threshold pressure and flow rate and reduced excitation of high-order harmonics, resulting in a more breathy and rough voice production. However, it was found that voice production was improved with the placement of scar, which increased both excitation of high-order harmonics and the harmonic-to-noise ratio.
  
  
  CONCLUSIONS
  Although large anterior-posterior surgical resections resulted in progressive impact on vocal measures, a limited excision of the vocal fold cover surprisingly demonstrated minimal voice changes. Further investigations are required to define the acceptable extent of surgical resection that may result in optimal voice outcomes.
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
authors.forename: Abie H
authors.initials: AH
authors.lastname: Mendelsohn
authors.forename: Yue
authors.initials: Y
authors.lastname: Xuan
authors.forename: Zhaoyan
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D005931:Glottis / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D053685:Laser Therapy; D008962:Models, Theoretical; D009367:Neoplasm Staging; D055585:Physical Phenomena; D016896:Treatment Outcome; D014827:Vocal Cords / Q000601:surgery; D014833:Voice Quality
keywords: Cancer; glottic; larynx; laser; vocal cord; voice