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Phonatory results after laser surgery for glottic carcinoma
C Sittel1, H E Eckel, C Eschenburg
1Department of Otorhinolaryngology-Head and Neck Surgery, University of Cologne, Germany.
Summary
Surgery type and extent significantly impact voice quality after endoscopic laser resection for glottic cancer. Preserving the anterior commissure improves outcomes, while extensive resections worsen them. Speech therapy showed no significant benefit.
Area of Science:
- Otolaryngology
- Oncology
- Speech Science
Background:
- Endoscopic laser resection is a common treatment for glottic carcinoma.
- Understanding the impact of surgical variables on voice outcomes is crucial for patient quality of life.
Purpose of the Study:
- To investigate how the type and extent of surgery influence postoperative voice parameters in patients with glottic carcinoma treated with endoscopic laser resection.
Main Methods:
- A prospective study involving 80 patients at a head and neck cancer center.
- Objective (relative phonetogram - RP) and subjective (otolaryngologist - TO, speech therapist - ST ratings) voice measures were collected.
- Videostroboscopy assessed the postoperative phonation mechanism.
Main Results:
- Simple cordectomy yielded better results (RP=24.8%, TO=3.26, ST=3.33) than extended cordectomy (RP=14.7%, TO=2.82, ST=3.00) or transglottic resection (RP=13.7%, TO=2.30, ST=2.86).
- Preservation of the anterior commissure significantly improved voice parameters (RP=34%, TO=3.92, ST=3.83).
- No significant difference in voice parameters was observed between patients who received speech therapy and those who did not.
Conclusions:
- Postoperative voice outcomes are closely linked to the phonation mechanism, not solely the amount of tissue removed.
- Preserving the anterior commissure is a key factor in achieving better voice results.
- The relative phonetogram (RP) is a valuable tool for voice assessment, and speech therapy did not demonstrate a significant benefit in this study.