Outcomes of Laryngeal Cancer Surgery after Open Partial Horizontal Laryngectomies with Lateral Cervical Approach

Abstract

Background: Open partial horizontal laryngectomies (OPHL) are one of the surgical techniques used for the conservative management of laryngeal cancers. The aims of this study are to analyze the oncological and functional results of a group of patients affected by laryngeal squamous cell carcinoma (LSCC) treated with OPHL, performed using a minimally invasive technique. Methods: This is a prospective case–control study. We enrolled 17 consecutive patients with LSCC treated with OPHL through a lateral cervical approach (LCA). Patients were evaluated using their Penetration Aspiration Scale score (liquid, semiliquid and solid) and Voice Handicap Index (VHI) at three different endpoints: 15 days (T1), 3 months (T2), and 6 months (T2) after surgery. Results: The functional outcomes of the LCA are stackable with that of the classical anterior cervical approach in terms of respiration, swallowing, and speech. One-way ANOVA was performed to evaluate the variances of PAS and VHI scores at the three different observation points. No statistically significant differences were observed between OPHL- PAS scores for liquid (p = 0.1) at the three different observation points. A statistically significant improvement was observed in the OPHL- PAS score for semisolids and solids (p < 0.00001) between T1 and T3 (p = 0.0001) and for solids between T2 and T3 (p < 0.00001). The improvement of VHI-10 was statistically significative (p < 0.00001) at the three different observation points (T1–T2 and T2–T3). Conclusion: The LCA is a potential approach for laryngeal surgery in selected cases. The preoperative staging and planning are of the utmost importance to ensure oncological radicality. The main advantage of this approach is the preservation of the healthy tissues surrounding the larynx and the functional and oncological outcomes are stackable with the classic anterior cervical approach.

Polycystic Ovary Syndrome and Alteration of Vocal Function: A Systematic Review and Meta-Analysis

“…Voice Handicap Index Information about perceived voice quality was assessed by standardized scales as the Voice Handicap Index 10 (VHI-10) in one study [4], and VHI is a 30item scale used in one different study [3]. The VHI is a 30-item instrument designed to examine the selfperceived emotional, physical, and functional effects of patients' voice dysfunction [10,11]. Gugatschka et al [3] reported in 34 patients no statistically significant difference in terms of mean VHI-30 German Version total score (p = 0.6), that was 8.1 (±9.5) in PCOS patients and 10.1 (±11.5) in the control group, respectively, or in subscales.…”

“…However, this study does not report the incidence of patients with a pathological score (cutoff >11). The VHI-10 is a valid instrument, with a slight loss of information with respect to the VHI-30, to quantify the patients' own perception of voice [10,11]. According to Aydin et al [4], pathologic scores in VHI-10 were found in a total of 52 women, in 6.7% (2/30) of patients affected by PCOS compared with 0% (0/22) of controls.…”