title: Subjective and objective voice outcomes after transoral laser microsurgery for early glottic cancer.
abstract: OBJECTIVE
  Transoral laser microsurgery (TLM) continues to gain popularity as a treatment modality for early glottic cancer. Oncologic outcomes have been well-defined, but there are little data to date describing functional outcomes accounting for stage of resection.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  We retrospectively reviewed patient-rated voice handicap and observer-rated vocal quality of patients who underwent TLM for early glottic carcinoma. Patients were grouped by European Laryngological Society (ELS) resection type, and the data were combined for ELS type I-III and compared with advanced resections (ELS IV-VI). The Voice Handicap Index (VHI) was used for patient-rated voice outcomes, and voice recordings were graded by two senior speech-language pathologists. Voice recordings and VHI scores were taken preoperatively and at least 1 month postoperatively.
  
  
  RESULTS
  No major complications were encountered. Six of 49 patients underwent repeat resection for suspicious findings with pathology, demonstrating moderate dysplasia in two cases, carcinoma in situ in two cases, and inflamed mucosa only in two cases. There was no significant difference in preoperative VHI scores or objective voice grades among patients who underwent limited (ELS I-III) and those who required more advanced (ELS IV-VI) resection. There was a significant improvement in VHI scores in patients after ELS type I to III resection, from 38.77 to 22.86 (P = .006). There was no significant difference between mean preoperative and postoperative perceptual evaluation scores in patients who underwent ELS type I, II, or III resections (62.25 and 64.32 respectively, P = .621).
  
  
  CONCLUSIONS
  Patients who undergo limited ELS resections can be assured of having a similar to improved voice after healing. Patients who undergo extended resections have poorer vocal outcomes.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, U.S.A.|Our Lady of the Lake Voice Center, Baton Rouge, Louisiana, U.S.A.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Fink
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, U.S.A.
authors.forename: Haley
authors.initials: H
authors.lastname: Sibley
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, U.S.A.|Our Lady of the Lake Voice Center, Baton Rouge, Louisiana, U.S.A.|Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, Louisiana, U.S.A.
authors.forename: Melda
authors.initials: M
authors.lastname: Kunduk
authors.affiliation: Our Lady of the Lake Voice Center, Baton Rouge, Louisiana, U.S.A.
authors.forename: Mell
authors.initials: M
authors.lastname: Schexnaildre
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, U.S.A.
authors.forename: Anagha
authors.initials: A
authors.lastname: Kakade
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, U.S.A.
authors.forename: Collin
authors.initials: C
authors.lastname: Sutton
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, U.S.A.|Our Lady of the Lake Voice Center, Baton Rouge, Louisiana, U.S.A.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: McWhorter
mesh_terms: D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009055:Mouth; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016896:Treatment Outcome; D014827:Vocal Cords / Q000503:physiopathology*; D014833:Voice Quality
keywords: Larynx; early glottic cancer; quality of life