title: Longitudinal Voice Outcomes Following Advanced CO2 Laser Cordectomy for Glottic Cancer.
abstract: OBJECTIVE
  CO2 laser cordectomy for glottic carcinoma offers excellent oncologic control on a per stage basis as compared with primary radiotherapy. We aim to further investigate the fluctuations of postoperative vocal outcomes following extended laser cordectomy for glottic cancer.
  
  
  METHODS
  Single center retrospective cohort study.
  
  
  METHODS
  Eleven patients with glottic squamous cell carcinoma (SCC) who received CO2 laser cordectomy European Laryngological Society type III-IV with complete datasets at preoperative, immediate postoperative (within 4 months), and delayed (greater than 6 months) time points were included.
  
  
  RESULTS
  All patients (n = 11) received cordectomy as their primary treatment. Tumor stage was divided evenly between T1 and T2. One patient was referred for post-cordectomy thyroplasty. Mean Voice Handicap Index (VHI) scores increased in the immediate postoperative period (43.3-46.2) but did not reach significance (P > 0.05). Delayed postoperative VHI (23.3) demonstrated substantial improvement from both pre- and immediate postoperative levels (P = 0.047). Objective voice rating significantly declined initially (P = 0.03; Grade, P = 0.01; Breathiness) and recovered to similar preoperative levels. Maximum phonation time (MPT) showed substantial decreases at the initial postoperative period (P = 0.007). Although significant improvement was made at the delayed postoperative point (P = 0.009), MPT remained below the preoperative level (P = 0.028). No significant changes were seen in phonatory subglottic pressures.
  
  
  CONCLUSIONS
  Patients undergoing extended CO2 laser cordectomy for glottic cancers can experience initial decline in voice quality; however, vocal function routinely returns to preoperative levels following the initial healing period. A small percentage of extended cordectomy patients may require further vocal interventions.
authors: Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California. Electronic address: AMendelsohn@mednet.ucla.edu.
authors: Abie H
authors: AH
authors: Mendelsohn
authors: Otolaryngology Head and Neck Surgery Department, Bellevue Medical Center, Hôtel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon.
authors: Nayla
authors: N
authors: Matar
authors: Otolaryngology Head and Neck Surgery Department, Catholic University of Louvain at Mont-Godinne, Yvoir, Belgium.
authors: Vincent
authors: V
authors: Bachy
authors: Otolaryngology Head and Neck Surgery Department, Catholic University of Louvain at Mont-Godinne, Yvoir, Belgium.
authors: Georges
authors: G
authors: Lawson
authors: Otolaryngology Head and Neck Surgery Department, Catholic University of Louvain at Mont-Godinne, Yvoir, Belgium.
authors: Marc
authors: M
authors: Remacle
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D053685:Laser Therapy; D054020:Lasers, Gas / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014831:Voice; D014833:Voice Quality
keywords: Cancer; Laryngeal preservation; Radiation; VHI; Vocal cord; Vocal fold