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Updated: Oct 15, 2025

CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Evolution of Voice Quality in Type 1-2 Transoral CO2 Laser Cordectomy: A Prospective Comparative Study
Jerome R Lechien1,2,3, Lise Crevier-Buchman3,4, Marta P Circiu3
1Department of Otolaryngology, Elsan Hospital, Paris, France.
Objectives/Hypothesis:
To compare the 12-month evolution of voice quality outcomes in patients who benefited from types 1-2 transoral CO2 laser cordectomy (TLC) for an early-stage vocal fold squamous cell carcinoma (VFSCC).
Study Design:
Prospective uncontrolled study.
Methods:
Sixty patients with cT1 VFSCC were consecutively recruited from a single medical center. Thirty patients benefited from type 1 TLC, while type 2 TCL was performed in 30 patients. The following voice quality outcomes were evaluated at baseline, 3-, 6-, and 12-month post-TLC: voice handicap index (VHI), GRBAS, speech rate, maximum phonation time (MPT), and acoustic parameters. Voice quality evolution was compared between type 1 and type 2 TLC.
Results:
Fifty-seven patients completed the evaluations. Type 1 TLC patients reported significant improvements of VHI, grade of dysphonia, and breathiness at 3-, 6-, and 12-month post-TLC. Speech rate and jitter values improved 6- and 12-month post-TLC. A few voice quality outcomes reported 3- or 6-month post-TLC improvements in type 2 TLC group, while VHI, grade of dysphonia improved at 6- and 12-month post-TLC. MPT significantly decreased at 6- and 12-month post-TLC, while there were no acoustic measurement changes in type 2 TLC.
Conclusions:
The effect of TLC on voice quality may depend on the type of TLC. Type 1 TLC was associated with faster voice quality improvements compared with type 2 TLC. VHI and dysphonia grade were identified as the most relevant tool of voice changes irrespective to the TLC type.
Level Of Evidence:
3 Laryngoscope, 132:1421-1426, 2022.
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