Longitudinal analysis of voice quality in patients with early glottic cancer after transoral laser microsurgery

Chu, Pen–Yuan; Hsu, Yu‐Sheng; Lee, Tsung-Lun; Fu, Sherry; Wang, Limei; Kao, Ya-Chung

doi:10.1002/hed.21914

Cited by 37 publications

(73 citation statements)

References 33 publications

(49 reference statements)

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“…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%

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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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Section: Discussionmentioning

confidence: 94%

“…The minimum follow-up period from the completion of treatment to voice quality evaluation was set at 6 months since voice quality usually becomes stable after 6 months [18,19]. Voice quality was evaluated 6-12 months after completion of each treatment.…”

Section: Methodsmentioning

confidence: 99%

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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“…We also carried out evaluations at 1 month after surgery. Since in the literature (22) it has been shown that the best assessment of the postoperative results can be obtained at the 6 th month, we considered as results of this study the data obtained at the 6 th month evaluations. In the present study, we have also included specific correlations between subjective and objective tools.…”

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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“…An advantage of this technique is that it can be easily repeated in case of histologically proven positive or uncertain resection margins. [13] In this study, we determined that using radiofrequency ablation, excision of small lesions (T 1a-b ) in early stage laryngeal carcinomas damages the tissue and so commenting on these tissues in histopathological evaluation is difficult. However, cauterization with radiofrequency gives uncertain margins in the remaining surgical zone compared with conventional surgery.…”

Section: Discussionmentioning

confidence: 99%

Erken evre larenks karsinomunda konvansiyonel cerrahi ve transoral radyofrekans ablasyonunun histopatolojik sonuçlarının karşılaştırılması

Çukurova¹

2013

Kulak Burun Bogaz Ihtis Derg

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Objectives: This study aims to compare histopathological results of conventional surgery and transoral radiofrequency ablation in patients with early stage laryngeal carcinoma. Patients and Methods:Between January 2006 and May 2010, 36 patients (34 males, 2 females; mean age 61.6 years; range 43 to 77 years) who underwent partial laryngectomy in our clinic were retrospectively analyzed. All patients were randomized to partial laryngectomy with radiofrequency ablation or conventional surgery. Hoarseness due to early stage T1 and selected T2N0 vocal cord lesions was an indication for surgery. Of 20 patients receiving conventional surgery, 14 underwent partial laryngectomy, while six patients underwent cordectomy for the excision of tumors. Tumors were excised by transoral radiofrequency ablation in 16 patients. Results:We observed thermal artifacts in four patients undergoing conventional surgery and in 13 patients undergoing transoral radiofrequency ablation. There was also hemorrhage in 16 patients undergoing conventional surgery and in seven patients undergoing transoral radiofrequency ablation. Histopathological examination revealed that the surgical margins were safe in 10 patients after radiofrequency ablation. The specimens obtained from six patients showed thermal artifacts which complicated histopathological examination. Sixteen (80%) of 20 conventional surgery patients and nine (56%) of 16 radiofrequency ablation patients had safe surgical margins. Conclusion:In radiofrequency ablation, the surgical zone must be larger than in conventional surgery due to the high risk of tissue damage and complicated histopathological examination.Key Words: Laryngeal carcinoma; partial laryngectomy; radiofrequency ablation; surgical zone; transoral.Amaç: Bu çalışmada erken evre larenks karsinomlu hastalarda konvansiyonel cerrahi ve transoral radyofrekans ablasyonunun histopatolojik sonuçları karşılaştırıldı. Hastalar ve Yöntemler:Ocak 2006 -Mayıs 2010 tarihleri arasında kliniğimizde parsiyel larenjektomi yapılan 36 hasta (34 erkek, 2 kadın; ort. yaş: 61.6 yıl; dağılım: 43-77 yıl) retrospektif olarak incelendi. Hastaların tümü radyofrekans ablasyonu ile birlikte parsiyel larenjektomiye veya konvansiyonel cerrahiye randomize edildi. Erken evre T1 ve seçilmiş T2N0 vokal kord lezyonlarına bağlı ses kısıklığı, cerrahi endikasyonuydu. Konvansiyonel cerrahi uygulanan 20 hastanın 14'ünde parsiyel larenjektomi, altısında kordektomi ile tümörler eksize edildi. On altı hastada ise transoral radyofrekans ablasyon ile tümörler alındı. Bulgular: Konvansiyonel cerrahi yapılan dört hastada ve transoral radyofrekans ablasyon uygulanan 13 hastada termal artefaktlar gözlendi. Konvansiyonel cerrahi yapılan 16 hastada ve transoral radyofrekans ablasyon uygulanan yedi hastada ise kanama vardı. Histopatolojik incelemede radyofrekans ablasyonundan sonra 10 hastada cerrahi sınırların güvenli olduğu tespit edildi. Altı hastadan alınan örneklerde, histopatolojik incelemeyi güçleştiren termal artefaktlar izlendi. Konvansiyonel cerrahi yapılan 20 ha...

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Longitudinal analysis of voice quality in patients with early glottic cancer after transoral laser microsurgery

Cited by 37 publications

References 33 publications

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

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

Erken evre larenks karsinomunda konvansiyonel cerrahi ve transoral radyofrekans ablasyonunun histopatolojik sonuçlarının karşılaştırılması

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