T1a Glottic Cancer: Advances in Vocal Outcome Assessment after Transoral CO2-Laser Microsurgery Using the VEM

Song, Wen; Caffier, Felix; Nawka, Tadeus; Ermakova, Tatiana; Martin, Alexios; Mürbe, Dirk; Caffier, Philipp P.

doi:10.3390/jcm10061250

Cited by 5 publications

(5 citation statements)

References 83 publications

(20 reference statements)

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“…Calculating the median between Max J and Max CCC is not a commonly used method for solving these problems. However, based on the frequent use of the VHI-9i in clinical investigations [ 18 , 19 , 20 , 21 , 22 , 31 , 36 , 41 ], it appears that the new classification will be a practical option for clinical settings.…”

Section: Discussionmentioning

confidence: 99%

“…A detailed discussion of the item and scale development can be found in the original VHI-9i publication [ 14 ]. In everyday diagnostic practice, the German translation of the VHI-9i is widely used by laryngologists and phoniatricians in German-speaking countries (e.g., [ 18 , 19 , 20 , 21 , 22 ]). Despite its clinical adoption, the reliability and validity of this VHI short scale as well as its classification have not yet been statistically verified.…”

Section: Introductionmentioning

confidence: 99%

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Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i)

Caffier

Nawka

Neumann

et al. 2021

JCM

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The international nine-item Voice Handicap Index (VHI-9i) is a clinically established short-scale version of the original VHI, quantifying the patients’ self-assessed vocal handicap. However, the current vocal impairment classification is based on percentiles. The main goals of this study were to establish test–retest reliability and a sound statistical basis for VHI-9i severity levels. Between 2009 and 2021, 17,660 consecutive cases were documented. A total of 416 test–retest pairs and 3661 unique cases with complete multidimensional voice diagnostics were statistically analyzed. Classification candidates were the overall self-assessed vocal impairment (VHIs) on a four-point Likert scale, the dysphonia severity index (DSI), the vocal extent measure (VEM), and the auditory–perceptual evaluation (GRB scale). The test–retest correlation of VHI-9i total scores was very high (r = 0.919, p < 0.01). Reliability was excellent regardless of gender or professional voice use, with negligible dependency on age. The VHIs correlated best with the VHI-9i, whereas statistical calculations proved that DSI, VEM, and GRB are unsuitable classification criteria. Based on ROC analysis, we suggest modifying the former VHI-9i severity categories as follows: 0 (healthy): 0 ≤ 7; 1 (mild): 8 ≤ 16; 2 (moderate): 17 ≤ 26; and 3 (severe): 27 ≤ 36.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i)

Caffier

Nawka

Neumann

et al. 2021

JCM

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“…More recently, early glottic carcinoma has been treated using either CO 2 -LS or RT, since both these treatments are associated with good oncological and survival outcomes [6]. However, many patients may prefer CO 2 -LS over RT due to its association with minimal morbidity and high rate of laryngeal preservation, radiotherapy as the further adjuvant therapy after surgery after a [7,8]. Furthermore, CO 2 -LS is considered to be a salvage treatment for recurrent laryngeal cancer after RT failure, since it can decrease the length of treatment and hospital stay, as well as reduce the incidence of side effects [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Is CO2 laser microsurgery better than radiotherapy in early glottic cancer: a meta-analysis

Yang,

Wang,

Wei

et al. 2023

Lasers Med Sci

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The choice between radiotherapy (RT) and CO2 laser surgery (CO2-LS) for early glottic cancer remains controversial. We systematically examined electronic databases in order to identify prospective trials comparing patients who had undergone CO2-LS or RT to treat early glottic cancer. Eleven studies involving 1053 patients were included. In the selected literature, the parameter setting of CO2 laser equipment can be summarized as wavelength 10.6 µm, superpulsed mode, continuous setting, power tailored on target structures (1–3 W for subtle resections and 4–15 W for cutting a larger tumor), and approximately 2080–3900 W/cm2 of laser energy. Using RevMan 5.3, we estimated pooled odds ratios (ORs) for dichotomous variables and pooled mean differences (MDs) for continuous variables, along with associated 95% confidence intervals (CIs). The heterogeneity in the treatment variables was measured using Higgins’ inconsistency test and expressed as I2 values. The continuous variables were then depicted as histograms developed using PlotDigitizer 2.6.8. Compared to patients treated with CO2-LS, those treated with RT had better jitter (MD 1.27%, 95% CI 1.21 ~ 1.32, P < 0.001), and high scores on the “Grade (MD 6.54, 95% CI 5.31 ~ 7.76, P < 0.001), Breathiness (MD 9.08, 95% CI 4.02 ~ 14.13, P < 0.001), Asthenia (MD 2.13, 95% CI 0.29 ~ 3.98, P = 0.02), and Strain (MD 3.32, 95% CI 0.57 ~ 6.07, P = 0.02)” scale. Patients treated with CO2-LS had worse local control rates (OR 3.14, 95% CI 1.52 ~ 6.48, P = 0.002) while lower incidence of second primary tumor (OR 0.30, 95% CI 0.15 ~ 0.61, P < 0.001). It is hoped that retrospective analysis can provide suggestions for early glottis patients to choose personalized treatment.

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“…Wuyts et al’s DSI model, presented in 2000, is a multivariate model that provides an objective and quantitative indicator of overall voice quality by incorporating acoustic (jitter, and the lowest intensity and highest fundamental frequency in the vocal range profile) and aerodynamic (maximum phonation time of the vowel [a:]) markers [ 9 ]. DSI has been regarded as a valuable and viable assessment for assessing overall voice quality, voice treatment, vocal training, and phonosurgery results [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Additional research found connections between the DSI and auditory-perceptual judgment and quality of life evaluation, establishing the DSI as a valid approach for evaluating dysphonia severity [ 13 , 14 , 15 , 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Accuracy Analysis of the Multiparametric Acoustic Voice Indices, the VWI, AVQI, ABI, and DSI Measures, in Differentiating between Normal and Dysphonic Voices

Uloza,

Pribuišis,

Ulozaite-Staniene

et al. 2023

JCM

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The study aimed to investigate and compare the accuracy and robustness of the multiparametric acoustic voice indices (MAVIs), namely the Dysphonia Severity Index (DSI), Acoustic Voice Quality Index (AVQI), Acoustic Breathiness Index (ABI), and Voice Wellness Index (VWI) measures in differentiating normal and dysphonic voices. The study group consisted of 129 adult individuals including 49 with normal voices and 80 patients with pathological voices. The diagnostic accuracy of the investigated MAVI in differentiating between normal and pathological voices was assessed using receiver operating characteristics (ROC). Moderate to strong positive linear correlations were observed between different MAVIs. The ROC statistical analysis revealed that all used measurements manifested in a high level of accuracy (area under the curve (AUC) of 0.80 and greater) and an acceptable level of sensitivity and specificity in discriminating between normal and pathological voices. However, with AUC 0.99, the VWI demonstrated the highest diagnostic accuracy. The highest Youden index equaled 0.93, revealing that a VWI cut-off of 4.45 corresponds with highly acceptable sensitivity (97.50%) and specificity (95.92%). In conclusion, the VWI was found to be beneficial in describing differences in voice quality status and discriminating between normal and dysphonic voices based on clinical diagnosis, i.e., dysphonia type, implying the VWI’s reliable voice screening potential.

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T1a Glottic Cancer: Advances in Vocal Outcome Assessment after Transoral CO2-Laser Microsurgery Using the VEM

Cited by 5 publications

References 83 publications

Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i)

Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i)

Is CO2 laser microsurgery better than radiotherapy in early glottic cancer: a meta-analysis

Accuracy Analysis of the Multiparametric Acoustic Voice Indices, the VWI, AVQI, ABI, and DSI Measures, in Differentiating between Normal and Dysphonic Voices

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