Pathologic Effects of External-Beam Irradiation on Human Vocal Folds

Berg, Eric E.; Kolachala, Vasantha L.; Branski, Ryan C.; Müller, Susan; Johns, Michael M.

doi:10.1177/000348941112001109

Cited by 12 publications

(13 citation statements)

References 10 publications

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“…However, during the late post-RT phase, there was a significant decrease in the proportion of patients with complete glottic closure (67%; 40 of 60, n = 15; P = 0.01). These results suggest a decline in function due to adverse treatment effect such as radiation-induced fibrosis, a well characterized late complication following RT (26–29). …”

Section: Resultsmentioning

confidence: 84%

Evaluating Post-Radiotherapy Laryngeal Function with Laryngeal Videostroboscopy in Early Stage Glottic Cancer

et al. 2017

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ObjectiveDysphonia is common among patients with early stage glottic cancer. Laryngeal videostroboscopy (LVS) has not been routinely used to assess post-radiotherapy (RT) voice changes. We hypothesized that LVS would demonstrate improvement in laryngeal function after definitive RT for early-stage glottic cancer.Study designBlinded retrospective review of perceptual voice and stroboscopic parameters for patients with early glottic cancer and controls.SettingHigh-volume, single-institution academic medical center.Subjects and methodsFifteen patients underwent RT for Tis-T2N0M0 glottic cancer and were evaluated with serial LVS exams pre- and post-RT. Stroboscopic assessment included six parameters: vocal fold (VF) vibration, VF mobility, erythema/edema, supraglottic compression, glottic closure, and secretions. Grade, roughness, breathiness, asthenia, strain (GRBAS) voice perceptual scale was graded in tandem with LVS score. Assessments were grouped by time interval from RT: pre-RT, 0–4, 4–12, and >12 months post-RT.Results60 LVS exams and corresponding GRBAS assessments were reviewed. There were significant improvements in ipsilateral VF motion (P = 0.03) and vibration (P = 0.001) and significant worsening in contralateral VF motion (P < 0.001) and vibration (P = 0.008) at >12 months post-RT. Glottic closure significantly worsened, most prominent >12 months post-RT (P = 0.01). Composite GRBAS scores were significantly improved across all post-RT intervals.ConclusionLVS proved to be a robust tool for assessing pre- and post-RT laryngeal function. We observed post-RT improvement in ipsilateral VF function, a decline in contralateral VF function, and decreased glottic closure. These results demonstrate that LVS can detect meaningful changes in VF and glottic function and support its use for post-RT evaluation of glottic cancer patients.

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Section: Resultsmentioning

confidence: 84%

Evaluating Post-Radiotherapy Laryngeal Function with Laryngeal Videostroboscopy in Early Stage Glottic Cancer

et al. 2017

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“…The morbidity from radiation to the vocal folds for glottic larynx tumors has been described extensively and more recent data have also confirmed some decreased laryngeal function following radiation for nonglottic head and neck tumors. 24 Berg and colleagues 25 reported the pathologic effects of external-beam irradiation on human vocal folds. A blinded, controlled study of archived tissue, postirradiation salvage laryngectomy vocal fold tissue was evaluated.…”

Section: Physiopathologymentioning

confidence: 99%

RETRACTED: Laryngeal Function After Radiation Therapy

Gamez

Harrison

2015

Otolaryngologic Clinics of North America

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“…Several studies have characterized pathological changes in laryngeal structural levels in human specimens . It is believed that radiation‐induced fibrosis is critical to late effects of radiation damage to the larynx.…”

Section: Introductionmentioning

confidence: 99%

“…1,5 Several studies have characterized pathological changes in laryngeal structural levels in human specimens. [6][7][8] It is believed that radiation-induced fibrosis is critical to late effects of radiation damage to the larynx. Radiation-induced fibrosis leads to stiffening and loss of pliability of VFs, which contributes to clinically relevant dysphonia.…”

Section: Introductionmentioning

confidence: 99%