title: Vocal function after transoral videolaryngoscopic surgery (TOVS) for hypopharyngeal and supraglottic cancer.
abstract: CONCLUSIONS
  The resection of the medial and lateral pyriform sinus was associated with post-operative voice impairment after TOVS. Scar contracture around the cricoarytenoid joint lead to arytenoid fixation toward lateral position, and this wound healing process caused insufficient glottis closure. Although oncological and functional outcomes of TOVS was satisfactory, surgeons should mention the risk of post-operative voice impairment in pre-operative counseling.
  
  
  OBJECTIVE
  Transoral surgery is a minimally invasive treatment option for hypopharyngeal and supraglottic cancer. Post-operative vocal function was satisfactory in most cases, but in some cases vocal cord was fixed and occasionally voice impairment persists.
  
  
  METHODS
  Vocal function of 55 patients who underwent transoral videolaryngoscopic surgery (TOVS) for hypopharyngeal and supraglottic cancers was evaluated by the GRBAS perceptive scale, aerodynamic tests and acoustic analyses, and the Voice Handicap Index questionnaire. The risk factors for voice impairment were identified.
  
  
  RESULTS
  Voice impairment (G score ≧2) was found in 16 cases (29.1%). Univariate analysis revealed that the resection of medial and lateral pyriform sinus (p = .0018) and neck dissection (p = .0421) were associated with post-operative voice impairment. Multivariate analysis revealed that the resection of medial and lateral pyriform sinus (p = .0021) was associated with post-operative voice impairment.
authors.affiliation: a Department of Otolaryngology-Head and Neck Surgery , National Defense Medical College , Saitama , Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: a Department of Otolaryngology-Head and Neck Surgery , National Defense Medical College , Saitama , Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tomifuji
authors.affiliation: a Department of Otolaryngology-Head and Neck Surgery , National Defense Medical College , Saitama , Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Araki
authors.affiliation: a Department of Otolaryngology-Head and Neck Surgery , National Defense Medical College , Saitama , Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Uno
authors.affiliation: a Department of Otolaryngology-Head and Neck Surgery , National Defense Medical College , Saitama , Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: a Department of Otolaryngology-Head and Neck Surgery , National Defense Medical College , Saitama , Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Mizokami
authors.affiliation: a Department of Otolaryngology-Head and Neck Surgery , National Defense Medical College , Saitama , Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: a Department of Otolaryngology-Head and Neck Surgery , National Defense Medical College , Saitama , Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyagawa
authors.affiliation: a Department of Otolaryngology-Head and Neck Surgery , National Defense Medical College , Saitama , Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Taniai
authors.affiliation: a Department of Otolaryngology-Head and Neck Surgery , National Defense Medical College , Saitama , Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shiotani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007828:Laryngoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010699:Phonation; D011183:Postoperative Complications / Q000209:etiology; D056144:Pyriform Sinus / Q000601:surgery; D012189:Retrospective Studies; D013061:Speech Acoustics; D014831:Voice; D014832:Voice Disorders / Q000209:etiology*
keywords: Transoral videolaryngoscopic surgery; laryngopharyngeal cancer; risk analysis; vocal function