title: Assessment of vocal quality following treatment of advanced pharyngo-laryngeal carcinoma with a protocol of organ preservation.
abstract: OBJECTIVE
  Advanced laryngeal and pharyngeal cancer, as well as methods to treat them, have a direct impact on voice function, speech communication and deglutition. Such alterations in function can influence employability and general quality of life.
  
  
  METHODS
  To characterise the vocal status of the patients treated with an organ-preservation protocol, we report the voice outcomes of 17 patients who were alive and disease free at the time of the survey, with a minimum follow-up of 6 months, after a combination of radiotherapy and chemotherapy to treat advanced cancer. Objective voice assessment by means of spectrographic analysis, the GRBAS perceptual analysis system and the Voice Handicap Index was the methodology followed, which we suggest could be used in future large-scale investigations.
  
  
  RESULTS
  Normal or slightly dysphonic voices were observed in 5 patients (29.4%) and moderate/severe in 12 (70.6%). Spectrographically, the 17 samples were classified as normal in 4 cases (23.4%), Grade I in 3 cases (17.6%), Grade II in 3 (17.6%), Grade III in 4 (23.5%) and Grade IV in 2 (11.7%). The Voice Handicap Index questionnaire, which was completed by the patients themselves, gave normal results in all the patients except for 4 (23.5%).
  
  
  CONCLUSIONS
  The voice acoustic analysis of this series shows that the damage related to the organ-preservation protocol displays a relatively wide range of voice function outcomes. To characterise the vocal status of these patients reliably, we propose using homogeneous instruments (spectrography, GRBAS scale, Maximum Phonation Time and Voice Handicap Index) in future meta-analyses.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Morato-Galán
authors.affiliation: Servicio de Oncología Radioterápica, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Caminero Cueva
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Asturias, España.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Rodrigo
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Asturias, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Suárez Nieto
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España. Electronic address: fnunezb@telefonica.net.
authors.forename: Faustino
authors.initials: F
authors.lastname: Núñez-Batalla
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000601:surgery*; D059351:Organ Sparing Treatments; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D014833:Voice Quality
keywords: Análisis de voz; Cáncer de cabeza y cuello; Functional outcomes; Head and neck cancer; Resultados funcionales; Voice analysis