Voice evaluation following endoscopic laser CO(2) cordectomy and conventional cordectomy

An analysis of long term voice quality outcomes of two different types of surgical intervention for Tis and T1 glottic carcinoma: laryngofissure conventional cordectomy and endoscopic laser CO(2) cordectomy, with or without additional radiation therapy.

Total of 46 patients with Tis and T1 glottic carcinoma served as subjects. All have been treated surgically with laryngofissure conventional cordectomy (32.61%) or endoscopic laser CO(2) cordectomy (67.39%). The surgeries were performed in the Department of Otolaryngology at the Medical University of Warsaw (1990-2004). The presented voice assessments were made at least 3 years following the surgery, in between January 2006 and February 2007.

In patients after the endoscopic laser CO(2) cordectomy the following findings are more often observed: the unrestrained voice production, wider range of Fo in a spoken sentence, longer maximum phonation time, better intensity of phonation for normal and loud speaking, lower degree of hoarseness based on the Yanagihara's classification, and the lower VHI. No significant influence of the performed additional radiotherapy on voice parameters was found.

Patients after endoscopic laser CO(2) cordectomy, compared to laryngofissure conventional cordectomy, present better voice quality. The amount of the excised vocal fold tissue, which in our study was slightly larger in case of the conventional cordectomy, could account for the results mentioned above. This may also be explained by the necessity of the anterior thyrotomy, which is required for conventional cordectomy via external approach, and often results in anterior synechia and level difference between the neocord and the contralateral vocal fold.