Vocal function following laser and conventional surgery of small malignant vocal fold tumours

Keilmann, Annerose; Bergler, W.; Artzt, Martina; Hörmann, K.

doi:10.1017/s0022215100135959

Cited by 37 publications

(34 citation statements)

References 20 publications

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“…In 56 patients with stage III and IV cancer the 5-year overall survival rate was 48.8%, with a local recurrence rate of 19.5%. Since many years we are using the CO 2 laser in the treatment of benign lesions of the larynx and early stage T1 and T2 T 1 0 0 0 0 0 0 0 T 2 0 0 1 0 0 0 1 T 3 1 1 0 1 1 0 4 T 4 1 2 1 2 3 1 1 0 Total 2 3 2 3 4 1 1 5 malignant tumors of the larynx with excellent control rates and preservation of the function [6][7][8]. In advanced laryngeal carcinomas we recommend, similar to the suggestion of Iro et al, the use of laser surgery in a combined treatment modality with postoperative irradiation since surgery or radiotherapy alone do not yield promising control rates [10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Preliminary Oncological Results of a Multimodality Treatment Regimen with Transoral Laser Surgery, Neck Dissection and Postoperative Irradiation in Advanced Laryngeal Carcinomas

Sadick¹,

Riedel²,

Bergler³

et al. 2000

Oncol Res Treat

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Background: CO₂ laser surgery is a generally accepted treatment modality in early stage I cancers. The aim of our study was to determine the role of transoral laser surgery in a multimodality treatment regimen with neck dissection and postoperative irradiation in advanced laryngeal carcinomas. Patients and Methods: From June 1993 to December 1996 we examined 40 patients (32 men, 8 women; mean age 59 years) with advanced laryngeal squamous cell carcinomas (stages III and IV: 95%, stage II: 5%) who underwent a multimodality treatment regimen with transoral laser surgery, bilateral neck dissection, and postoperative irradiation. Median follow-up time was 39 months. Results: The 3-year overall survival rate was 85%. The local and regional recurrence rates were 37.5 and 27.5%, respectively. Postoperative complications which were related to the laser surgical intervention occurred in 5 patients (12.5%). Conclusions: The oncological results of transoral CO₂ laser surgery combined with bilateral neck dissection and postoperative irradiation are satisfying if clean surgical tumor margins (R0) can be reached. In patients in whom tumor-free margins are not achieved (R1 and R2 resections) and transoral revision is not possible, transcervical procedures (total or partial laryngectomy) should be performed. The 3-year overall survival rate of 85% following laser surgery with bilateral neck dissection and postoperative irradiation indicates a promising alternative to other combined treatment modalities which include radical laryngectomy.

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Section: Discussionmentioning

confidence: 99%

Preliminary Oncological Results of a Multimodality Treatment Regimen with Transoral Laser Surgery, Neck Dissection and Postoperative Irradiation in Advanced Laryngeal Carcinomas

Sadick¹,

Riedel²,

Bergler³

et al. 2000

Oncol Res Treat

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“…The advantages of laser resection include minimal bleeding, precise control of resection and the absence of postoperative edema [7] . Compared to open cordectomy superior voice quality was measured in patients after laser surgery [8] .…”

Section: Introductionmentioning

confidence: 99%

Long-Term Functional Outcome after Unilateral Cordectomy

Keilmann¹,

Napiontek²,

Engel³

et al. 2010

ORL

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Purpose of the Study: Our aim was to longitudinally analyze the vocal outcome after endoscopic CO₂ laser resection of early glottic carcinoma. Procedures: Sixteen patients treated with laser surgery for T1 or T2 tumors of the vocal cords received voice therapy and were examined 1, 2, 3, 4.5, 6 and 12 months postoperatively. Besides videolaryngostroboscopy, each examination included history, phonetogram of the speaking and the singing voice, language-specific hoarseness diagram and a questionnaire (Voice Handicap Index 12 in German). Results: Objective parameters demonstrated a broad variability with a slight tendency of improvement over time. For the maximal phonation time a nearly constant improvement was seen. After an initial improvement deterioration for subjective assessment in the Voice Handicap Index was noted in most patients 3–6 months postoperatively. Conclusions: The functional outcome after cordectomy is variable. Message of the Paper: Discrepancies between objective findings and patient satisfaction over time have to be considered after cordectomy.

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“…The quality of voice after endoscopic cordectomy has been assessed [20,21,33] and compared to voice quality after radiotherapy or open cordectomy [1,5,8,19,22,24,31]. Currently, no agreement exists in terms of voice preservation after treatment addressing early cancer of the vocal cord: there is no consensus in favor [4,31] or disfavor of radiotherapy [5,8,22] or in favor [19] or disfavor [1,24] of open surgery.…”

Section: Introductionmentioning

confidence: 99%

Medialization framework surgery for voice improvement after endoscopic cordectomy

Ramacle¹,

Lawson²,

Abbastabar³

et al. 2001

European Archives of Oto-Rhino-Laryngology

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Seven dysphonic patients who had previously undergone total or extended cordectomy underwent laryngeal framework medialization. A minimum 6-month period between cordectomy and framework surgery was enforced to allow the vocal cord to scar and form a fibrous "neocord", to evaluate the voice recovery achieved by speech therapy alone and avoid the risk of operating on a patient with undiagnosed early recurrence. The operation is performed with fiberscopic control under general anesthesia. These operating conditions are required because undermining the fibrous tissue at the inner side of the thyroid ala is a lengthy and laborious procedure. This step is necessary to ensure easy placement of the implant. Caution must be taken to avoid tearing the fibrous tissue, with consequent risk of prosthesis extrusion. The cartilage window is left intact. Whereas cartilage implants remain indicated for minor gaps, we advocate Friedrich's implant for wider gaps. The vocal outcome revealed an increased median maximum phonation time from 5 s (range 2-12 s) to 7.5 s (range 3-23 s); a reduced phonation quotient from 516.5 ml/s (range 235-1000 ml/s) to 222 ml/s (range 146-595 ml/s); a slightly increased modal intensity from 61.5 dB (range 57-75 dB) to 67 dB (range 46-68 dB); an improved intensity range from 24.5 dB (range 16-36 dB) to 30 dB (range 16-62 dB); a steady fundamental frequency from 150 Hz (range 132-290) to 152 Hz (range 125-200); and an increased median spectral analysis class from 2 (range 1-3) to 3 (range 2-4). Subjectively, the patients noted that, throughout the day, phonation required less effort and induced less vocal fatigue.

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Vocal function following laser and conventional surgery of small malignant vocal fold tumours

Cited by 37 publications

References 20 publications

Preliminary Oncological Results of a Multimodality Treatment Regimen with Transoral Laser Surgery, Neck Dissection and Postoperative Irradiation in Advanced Laryngeal Carcinomas

Preliminary Oncological Results of a Multimodality Treatment Regimen with Transoral Laser Surgery, Neck Dissection and Postoperative Irradiation in Advanced Laryngeal Carcinomas

Long-Term Functional Outcome after Unilateral Cordectomy

Medialization framework surgery for voice improvement after endoscopic cordectomy

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