Daniel S Fink1,2, Haley Sibley1, Melda Kunduk1,2,3, Mell Schexnaildre2, Anagha Kakade1, Collin Sutton1, Andrew J McWhorter1,2. 1. Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, U.S.A. 2. Our Lady of the Lake Voice Center, Baton Rouge, Louisiana, U.S.A. 3. Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, Louisiana, U.S.A.
Abstract
OBJECTIVES/HYPOTHESIS: Transoral laser microsurgery (TLM) continues to gain popularity as a treatment modality for early glottic cancer. Oncologic outcomes have been well-defined, but there are little data to date describing functional outcomes accounting for stage of resection. STUDY DESIGN: Retrospective review. METHODS: We retrospectively reviewed patient-rated voice handicap and observer-rated vocal quality of patients who underwent TLM for early glottic carcinoma. Patients were grouped by European Laryngological Society (ELS) resection type, and the data were combined for ELS type I-III and compared with advanced resections (ELS IV-VI). The Voice Handicap Index (VHI) was used for patient-rated voice outcomes, and voice recordings were graded by two senior speech-language pathologists. Voice recordings and VHI scores were taken preoperatively and at least 1 month postoperatively. RESULTS: No major complications were encountered. Six of 49 patients underwent repeat resection for suspicious findings with pathology, demonstrating moderate dysplasia in two cases, carcinoma in situ in two cases, and inflamed mucosa only in two cases. There was no significant difference in preoperative VHI scores or objective voice grades among patients who underwent limited (ELS I-III) and those who required more advanced (ELS IV-VI) resection. There was a significant improvement in VHI scores in patients after ELS type I to III resection, from 38.77 to 22.86 (P = .006). There was no significant difference between mean preoperative and postoperative perceptual evaluation scores in patients who underwent ELS type I, II, or III resections (62.25 and 64.32 respectively, P = .621). CONCLUSIONS: Patients who undergo limited ELS resections can be assured of having a similar to improved voice after healing. Patients who undergo extended resections have poorer vocal outcomes. LEVEL OF EVIDENCE: 4.
OBJECTIVES/HYPOTHESIS: Transoral laser microsurgery (TLM) continues to gain popularity as a treatment modality for early glottic cancer. Oncologic outcomes have been well-defined, but there are little data to date describing functional outcomes accounting for stage of resection. STUDY DESIGN: Retrospective review. METHODS: We retrospectively reviewed patient-rated voice handicap and observer-rated vocal quality of patients who underwent TLM for early glottic carcinoma. Patients were grouped by European Laryngological Society (ELS) resection type, and the data were combined for ELS type I-III and compared with advanced resections (ELS IV-VI). The Voice Handicap Index (VHI) was used for patient-rated voice outcomes, and voice recordings were graded by two senior speech-language pathologists. Voice recordings and VHI scores were taken preoperatively and at least 1 month postoperatively. RESULTS: No major complications were encountered. Six of 49 patients underwent repeat resection for suspicious findings with pathology, demonstrating moderate dysplasia in two cases, carcinoma in situ in two cases, and inflamed mucosa only in two cases. There was no significant difference in preoperative VHI scores or objective voice grades among patients who underwent limited (ELS I-III) and those who required more advanced (ELS IV-VI) resection. There was a significant improvement in VHI scores in patients after ELS type I to III resection, from 38.77 to 22.86 (P = .006). There was no significant difference between mean preoperative and postoperative perceptual evaluation scores in patients who underwent ELS type I, II, or III resections (62.25 and 64.32 respectively, P = .621). CONCLUSIONS:Patients who undergo limited ELS resections can be assured of having a similar to improved voice after healing. Patients who undergo extended resections have poorer vocal outcomes. LEVEL OF EVIDENCE: 4.
Authors: Lucia Staníková; Karol Zeleník; Martin Formánek; Jana Seko; Radana Walderová; Peter Kántor; Pavel Komínek Journal: Eur Arch Otorhinolaryngol Date: 2021-03-18 Impact factor: 2.503
Authors: Yda van Loon; Martine Hendriksma; Bas J Heijnen; Vivienne A H van de Kamp; Marieke M Hakkesteegt; Stefan Böhringer; Ton P M Langeveld; M A de Jong; W Martin C Klop; Robert J Baatenburg de Jong; Elisabeth V Sjögren Journal: Head Neck Date: 2019-01-16 Impact factor: 3.147
Authors: Ayham Al Afif; Matthew H Rigby; Colin MacKay; Timothy F Brown; Timothy J Phillips; Usman Khan; Jonathan R B Trites; Martin Corsten; S Mark Taylor Journal: J Otolaryngol Head Neck Surg Date: 2022-03-22