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Voice quality after CO2 laser cordectomy—What can we really expect?

✍ Scribed by Isabel Vilaseca; Paula Huerta; José Luis Blanch; Ana María Fernández-Planas; Conchita Jiménez; Manuel Bernal-Sprekelsen


Book ID
102233488
Publisher
John Wiley and Sons
Year
2007
Tongue
English
Weight
116 KB
Volume
30
Category
Article
ISSN
1043-3074

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✦ Synopsis


Abstract

Background.

Endoscopic management of laryngeal carcinoma has gained popularity among laryngologists based on the good oncologic and functional results. We evaluated the voice quality after laser cordectomy for early glottic cancer in a variety of vocal situations and its relation with the extension of resection and the age.

Methods.

We conducted a cross‐sectional study of voice quality in 42 consecutive male patients treated for T1 glottic carcinoma with laser cordectomy. Patients were compared with 21 controls. Voice quality was self‐assessed by the patients. Perceptual analysis was done by a speech pathologist on a running speech sample [GRBAS (grade, roughness, breathiness, asthenicity, strain)]. Acoustic analysis included fundamental frequency (F0), jitter, shimmer, noise to harmonic ratio (N/H), and maximum phonation time (MPT) on the sustained vowels /a/ and /i/, and on various running speech voice samples.

Results.

Distribution of the patients included in the study by T classification was as follows: Tis, n = 2 (4.8%); T1a, n = 35 (83.3%); and T1b, n = 5 (11.9%). Cordectomy types were: (I), 14%; (II), 26%; (III), 21%; and (V), 38%. Voice improved in almost 60% of patients, returning to normal in 45%. GRBAS showed significant differences between patients and controls and correlated with type of cordectomy. Acoustic analysis showed significant differences in F0, and jitter, with smaller differences in shimmer, N/H, and MPT.

Conclusion.

Voice quality after laser cordectomy differs from controls, but improves in a majority of patients after the surgery, with almost 50% of patients with subjective normal or near normal voice. Voice quality depends on type of cordectomy. © 2007 Wiley Periodicals, Inc. Head Neck, 2008