Multidimensional Voice Quality Evaluation After Transoral CO₂ Laser Cordectomy: A Prospective Study

Area of Science:

• Otolaryngology
• Oncology
• Speech and Voice Science

Background:

• Early glottic cancer treatment often involves transoral laser cordectomy (TLC).
• Different types of cordectomies exist, classified by the extent of vocal fold resection.
• Assessing voice quality changes post-TLC is crucial for patient outcomes.

Purpose of the Study:

• To investigate voice quality changes after transoral laser cordectomy (TLC) for early glottic cancer.
• To compare voice outcomes based on the type of cordectomy performed (European Laryngological Society classification).

Main Methods:

• 164 male patients with early glottic cancer were prospectively studied.
• Patients underwent CO2 laser cordectomy, types I-VI, based on tumor characteristics.
• Voice quality was assessed pre- and postoperatively using VHI, perceptual scales, phonation time, and acoustic/aerodynamic measures.

Main Results:

• 55 patients (Tis-T2) completed the study, divided into types I-III (n=34) and types IV-VI (n=21) TLC groups.
• Subjective voice quality (VHI, dysphonia grade, breathiness) significantly improved in both groups post-TLC.
• Patients undergoing less extensive TLC (types I-III) showed better voice outcomes than those with more extensive resections (types IV-VI).

Conclusions:

• Transoral laser cordectomy (TLC) significantly improves subjective voice quality in early glottic cancer patients.
• Less extensive TLC (types I-III) is associated with superior postoperative voice outcomes compared to more extensive types (IV-VI).
• The utility of acoustic and aerodynamic measurements for assessing voice quality changes post-TLC requires further investigation.