Abie H Mendelsohn1, Yue Xuan, Zhaoyan Zhang. 1. Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.
Abstract
OBJECTIVES/HYPOTHESIS: The voice effects following laser cordectomy for early glottic cancer are poorly described. We investigated the voice outcomes of subligamentous cordectomy of progressive anterior-posterior extent of excision. STUDY DESIGN: Physical phonatory modeling. METHODS: The influence of vocal fold surgical defects and corresponding scar was experimentally investigated using a self-oscillating physical model of the vocal folds and compared with the baseline model without defects or scar. RESULTS: Results showed that increasing anterior-posterior extent of resection increased phonation threshold pressure and flow rate and reduced excitation of high-order harmonics, resulting in a more breathy and rough voice production. However, it was found that voice production was improved with the placement of scar, which increased both excitation of high-order harmonics and the harmonic-to-noise ratio. CONCLUSIONS: Although large anterior-posterior surgical resections resulted in progressive impact on vocal measures, a limited excision of the vocal fold cover surprisingly demonstrated minimal voice changes. Further investigations are required to define the acceptable extent of surgical resection that may result in optimal voice outcomes.
OBJECTIVES/HYPOTHESIS: The voice effects following laser cordectomy for early glottic cancer are poorly described. We investigated the voice outcomes of subligamentous cordectomy of progressive anterior-posterior extent of excision. STUDY DESIGN: Physical phonatory modeling. METHODS: The influence of vocal fold surgical defects and corresponding scar was experimentally investigated using a self-oscillating physical model of the vocal folds and compared with the baseline model without defects or scar. RESULTS: Results showed that increasing anterior-posterior extent of resection increased phonation threshold pressure and flow rate and reduced excitation of high-order harmonics, resulting in a more breathy and rough voice production. However, it was found that voice production was improved with the placement of scar, which increased both excitation of high-order harmonics and the harmonic-to-noise ratio. CONCLUSIONS: Although large anterior-posterior surgical resections resulted in progressive impact on vocal measures, a limited excision of the vocal fold cover surprisingly demonstrated minimal voice changes. Further investigations are required to define the acceptable extent of surgical resection that may result in optimal voice outcomes.
Authors: M Remacle; H E Eckel; A Antonelli; D Brasnu; D Chevalier; G Friedrich; J Olofsson; H H Rudert; W Thumfart; M de Vincentiis; T P Wustrow Journal: Eur Arch Otorhinolaryngol Date: 2000 Impact factor: 2.503
Authors: Kim M Goor; A Jeanne G E Peeters; Hans F Mahieu; Johannes A Langendijk; C René Leemans; Irma M Verdonck-de Leeuw; Michel van Agthoven Journal: Head Neck Date: 2007-02 Impact factor: 3.147
Authors: Alexander T Hillel; Michael M Johns; Edie R Hapner; Manish Shah; Justin C Wise; Adam M Klein Journal: Ann Otol Rhinol Laryngol Date: 2013-03 Impact factor: 1.547
Authors: Isabel Vilaseca; Paula Huerta; José Luis Blanch; Ana María Fernández-Planas; Conchita Jiménez; Manuel Bernal-Sprekelsen Journal: Head Neck Date: 2008-01 Impact factor: 3.147
Authors: Christine D L van Gogh; Irma M Verdonck-de Leeuw; Jeanne Wedler-Peeters; Johannes A Langendijk; Hans F Mahieu Journal: Eur Arch Otorhinolaryngol Date: 2012-02-05 Impact factor: 2.503
Authors: William M Mendenhall; Robert P Takes; Jatin P Shah; Patrick J Bradley; Jonathan J Beitler; Primož Strojan; Carlos Suárez; Juan P Rodrigo; Nabil F Saba; Alessandra Rinaldo; Jochen A Werner; Alfio Ferlito Journal: Eur Arch Otorhinolaryngol Date: 2014-11-08 Impact factor: 2.503