Functional Outcomes after CO<sub>2</sub> Laser Treatment of Early Glottic Carcinoma

Ledda, Gian Peppino; Grover, Nancy; Pundir, Vishal; Masala, Ernestina; Puxeddu, Roberto

doi:10.1097/01.mlg.0000217557.45491.bd

Cited by 63 publications

(86 citation statements)

References 14 publications

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“…Endoscopic laser cordectomy has proven to be effective in terms of local control, survival and vocal function for early glottic carcinoma [1,2] . Compared to radiotherapy laser cordectomy was found to be equal [3,4] or superior [5,6] . The advantages of laser resection include minimal bleeding, precise control of resection and the absence of postoperative edema [7] .…”

Section: Introductionmentioning

confidence: 99%

Long-Term Functional Outcome after Unilateral Cordectomy

Keilmann¹,

Napiontek²,

Engel³

et al. 2010

ORL

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Purpose of the Study: Our aim was to longitudinally analyze the vocal outcome after endoscopic CO₂ laser resection of early glottic carcinoma. Procedures: Sixteen patients treated with laser surgery for T1 or T2 tumors of the vocal cords received voice therapy and were examined 1, 2, 3, 4.5, 6 and 12 months postoperatively. Besides videolaryngostroboscopy, each examination included history, phonetogram of the speaking and the singing voice, language-specific hoarseness diagram and a questionnaire (Voice Handicap Index 12 in German). Results: Objective parameters demonstrated a broad variability with a slight tendency of improvement over time. For the maximal phonation time a nearly constant improvement was seen. After an initial improvement deterioration for subjective assessment in the Voice Handicap Index was noted in most patients 3–6 months postoperatively. Conclusions: The functional outcome after cordectomy is variable. Message of the Paper: Discrepancies between objective findings and patient satisfaction over time have to be considered after cordectomy.

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Section: Introductionmentioning

confidence: 99%

Long-Term Functional Outcome after Unilateral Cordectomy

Keilmann¹,

Napiontek²,

Engel³

et al. 2010

ORL

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“…Compared to T1RT, type III cordectomy resulted in worse outcome in terms of the GRBAS perceptive scale (especially G and B scores) and aerodynamic tests, but it was equivalent in terms of acoustic analyses and VHI. In the literature, vocal parameters after type I and type II cordectomy were not significantly different from those of normal controls [17,26]. Other studies reported that type I and type II cordectomies provided better voice quality than did type III to type V excisions [19,27,28].…”

Section: Discussionmentioning

confidence: 94%

“…Laser cordectomy was classified into 6 types after the publication of the ELS classification. Since the posttreatment voice quality can be influenced by the type of cordectomy [16,17], the surgeon should be aware of the level of voice quality that can be expected after each type of cordectomy in comparison with RT or CRT and should inform patients of these facts. To our knowledge, this is the first article to evaluate the posttreatment voice quality from subjective and objective viewpoints and to compare these results after each type of cordectomy, RT and CRT for early glottic carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…The ELS classification for laser cordectomy is gaining popularity for evaluating the extent of surgical defects of the vocal cord. The literature suggests that voice quality after laser cordectomy is influenced by the type of cordectomy [16,17]. However, it is unknown which type of cordectomy is better, equivalent or worse compared with RT or CRT.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Voice Quality after Laser Cordectomy with That after Radiotherapy or Chemoradiotherapy for Early Glottic Carcinoma

Tomifuji

Araki

Niwa

et al. 2013

ORL

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Purpose of the Study: The present study aimed to compare the voice quality after each type of cordectomy with that after radiotherapy (RT) or chemoradiotherapy (CRT) for early glottic carcinoma. Procedures: The GRBAS perceptive scale [consisting of 5 domains: grade (G), roughness (R), breathiness (B), asthenia (A), and strain (S)], aerodynamic tests and acoustic analyses, and the Voice Handicap Index questionnaire were evaluated for 58 laser cordectomy cases and 40 RT or CRT cases. Multiple comparison tests were conducted between each type of cordectomy and RT or CRT. Results: No statistical difference was found between type I/II cordectomy and RT for T1 glottic carcinoma (T1RT), whereas T1RT showed a significantly better outcome than type III cordectomy (G score: p = 0.016, maximum phonation time: p < 0.01, mean flow rate: p < 0.01). Type IV cordectomy was equivalent to RT or CRT for T2 glottic carcinoma (T2RT/CRT), while types V and VI showed a worse voice quality than T2RT/CRT (G score: p = 0.038 to type VI, B score: p = 0.025 to type V and p = 0.032 to type VI, A score: p = 0.017 to type VI). Conclusions: Voice quality after laser cordectomy differs according to the type of cordectomy. Surgeons should inform patients about the expected voice quality after each treatment modality.

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“…Several Authors agree that all parameters of the GIRBAS system and VHI score have a sufficient level of reliability in clinical practice to rate different grades of dysphonia (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Subjective and Objective Tools in Transoral Laser Cordectomy for Early Glottic Cancer: Importance of Voice Handicap Index

Stomeo

Tosin

Morolli

et al. 2013

Int J Immunopathol Pharmacol

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Several studies in recent years have already reported good oncologic results with laser microsurgery in the treatment of early glottic carcinoma. We conducted a longitudinal voice evaluation, in patients with early glottic cancer who underwent transoral laser cordectomy, in order to assess the voice quality outcome and its relationship with objective and subjective (voice handicap index questionnaire and GIRBAS scale) means. Twenty-four previously untreated patients underwent transoral laser cordectomy for early glottic cancer. All patients underwent subjective and objective voice assessment according to the multidimensional voice protocol recommended by the European Laryngological Society including acoustic, perceptual and stroboscopic analysis combined to patient self assessment of voice (voice handicap index-VHI). These evaluations were performed before treatment and 6 months after the treatment. Vocal fold healing was complete in all cases by 6 months following surgery. Main voice parameters (subjective and objective) resulted improved at the 6-month control after surgery. In particular, voice handicap index (VHI) and GIRBAS scale resulted reliable for voice assessment and for the postoperative follow-up. In conclusion, VHI, GIRBAS, multidimensional voice program (MDVP) and spectroacoustic parameters showed a close trend in the present study, and this confirms the validity of the voice analysis performed by each tool.

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Functional Outcomes after CO₂ Laser Treatment of Early Glottic Carcinoma

Abstract: Good oncologic results and vocal outcomes with no difference between controls and subepithelial and subligamental cordectomies support the use of CO2 laser endoscopic surgery as the first line of treatment for early glottic cancer.

Cited by 63 publications

References 14 publications

Long-Term Functional Outcome after Unilateral Cordectomy

Long-Term Functional Outcome after Unilateral Cordectomy

Comparison of Voice Quality after Laser Cordectomy with That after Radiotherapy or Chemoradiotherapy for Early Glottic Carcinoma

Comparison of Subjective and Objective Tools in Transoral Laser Cordectomy for Early Glottic Cancer: Importance of Voice Handicap Index

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Functional Outcomes after CO2 Laser Treatment of Early Glottic Carcinoma

Abstract: Good oncologic results and vocal outcomes with no difference between controls and subepithelial and subligamental cordectomies support the use of CO2 laser endoscopic surgery as the first line of treatment for early glottic cancer.

Cited by 63 publications

References 14 publications

Long-Term Functional Outcome after Unilateral Cordectomy

Long-Term Functional Outcome after Unilateral Cordectomy

Comparison of Voice Quality after Laser Cordectomy with That after Radiotherapy or Chemoradiotherapy for Early Glottic Carcinoma

Comparison of Subjective and Objective Tools in Transoral Laser Cordectomy for Early Glottic Cancer: Importance of Voice Handicap Index

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Functional Outcomes after CO₂ Laser Treatment of Early Glottic Carcinoma