Multidimensional Voice Quality Evaluation After Transoral CO₂ Laser Cordectomy: A Prospective Study

Abstract

Objective: To investigate voice quality changes of patients treated by transoral laser cordectomy (TLC) for early glottic cancer according to the type of cordectomies. Methods: A total of 164 consecutive male patients with an early glottic cancer were prospectively recruited from the Department of Otolaryngology-Head and Neck Surgery of the Georges Pompidou European Hospital. Depending on the tumor characteristics, patients benefited from type I to VI CO 2 cordectomy regarding the European Laryngological Society classification. The following voice quality outcomes were pre-to postoperatively assessed: voice handicap index (VHI), perceptual grade of dysphonia, roughness, breathiness, maximum phonation time, and acoustic parameters. Results: Fifty-five patients with Tis, T1, or T2 vocal fold cancer completed the study (mean age: 61.7 years). Of these patients, 34 and 21 composed group 1 (types I-III TLC) and group 2 (types IV-VI TLC), respectively. Voice handicap index, grade of dysphonia, and breathiness significantly improved from pre-to 3-and 6-month posttreatment in group 1. In group 2, only VHI significantly improved from pre-to 3-and 6-month posttreatment. Acoustic and aerodynamic measurements did not change throughout the postoperative course. Patients with types I to III TLC exhibited better postoperative voice outcomes compared to those treated by types IV to VI TLC. Conclusion: Irrespective to the types of TLC, the subjective voice quality of patients treated by CO 2 laser cordectomy for early glottic cancer significantly improved from pre-to 3-and 6-month posttreatment. The usefulness of aerodynamic and acoustic measurements as postoperative outcomes of voice quality changes remain controversial and require future studies considering multidimensional assessment of voice.

Course of Self-Reported Dysphagia, Voice Impairment and Pain in Head and Neck Cancer Survivors

“…Patient-reported voice impairment significantly improved over the first three followup consultations. The same course was described in other publications, e.g., for transoral laser cordectomy [27]. In this publication, the main improvement in voice was within the first 6 months postoperatively, and in our cohort also, the main effect occurred from t1 to t2.…”

Evolution of Voice Quality in Type 1–2 Transoral CO2 Laser Cordectomy: A Prospective Comparative Study

“…To date, few studies investigated postoperative voice quality outcomes in types 1-2 TLC through subjective and objective voice evaluations. 6,[10][11][12][13] The primary finding of the present study reported that postoperative voice quality outcomes did not substantially differ among TLC groups. At most, we observed that patients with type 1 TLC showed an earlier overall subjective and objective voice quality improvements (6 months) compared to patients who benefited from type 2 TLC (12 months).…”

“…19 The primary limitation of this study was the low number of patients in both groups. However, in comparison with other publications, 12,13,16 the current study is one of the largest focusing on type 1-2 CO 2 TLCs. The lack of consideration of gender differences is an additional limitation of the study because gender remains important in the analysis of voice quality evaluations regarding the gender-related vocal fold anatomical and histological differences, 20 as well as differences in the postoperative inflammatory and healing processes.…”

“…Voice quality is one of the most important outcomes in patients who benefited from TLC for early stage VFSCC. To date, few studies investigated postoperative voice quality outcomes in types 1–2 TLC through subjective and objective voice evaluations 6,10–13 …”

Voice Quality Outcomes After Transoral CO2 Laser Cordectomy: A Longitudinal Prospective Study

“…0.500). 7 They performed the evaluation in separate rooms. The final score was the mean of both evaluations.…”