Effects of head and neck radiation therapy on vocal function

Area of Science:

• Otolaryngology
• Radiation Oncology
• Speech-Language Pathology

Background:

• Radiotherapy (RT) is a standard treatment for head and neck cancers.
• The larynx can receive high radiation doses even when not the primary tumor site.
• The impact of RT on the non-diseased larynx remains largely uncharacterized.

Purpose of the Study:

• To investigate the effects of RT on vocal function in patients treated for nonlaryngeal head and neck malignancies.
• To evaluate both subjective and objective parameters of voice quality post-radiotherapy.

Main Methods:

• A cross-sectional observational study design was employed.
• Videostroboscopy, aerodynamic analysis, and acoustic analysis were conducted.
• The Voice Handicap Index (VHI) was used for self-assessment of voice quality, with results compared to age- and gender-matched controls.

Main Results:

• A majority of patients showed increased supraglottal activity (ventricular fold constriction) on stroboscopy.
• Significant differences were observed in aerodynamic and acoustic voice parameters compared to normative data.
• 27% of patients reported a significant voice handicap, with younger patients experiencing greater handicap and voice quality declining over time.

Conclusions:

• Radiotherapy for nonlaryngeal head and neck malignancies leads to significant objective and subjective vocal function changes.
• Younger patients appear to be disproportionately affected, with vocal dysfunction potentially increasing over time.
• Future prospective studies should incorporate baseline voice assessments for this patient population.