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. 2021 Aug;278(8):2899-2906.
doi: 10.1007/s00405-021-06751-3. Epub 2021 Mar 18.

Evolution of voice after transoral laser cordectomy for precancerous lesions and early glottic cancer

Lucia Staníková  1 , Karol Zeleník  2   3 , Martin Formánek  1   4 , Jana Seko  1 , Radana Walderová  1 , Peter Kántor  1   4 , Pavel Komínek  1   4
Affiliations

Evolution of voice after transoral laser cordectomy for precancerous lesions and early glottic cancer

Lucia Staníková et al. Eur Arch Otorhinolaryngol. 2021 Aug.

Abstract

Purpose: To evaluate voice quality evolution after a transoral laser cordectomy (TLC) for precancerous lesions and early glottic cancer.

Methods: This prospective study enrolled 18 patients scheduled for TLC for high-grade dysplasia, Tis, T1, and T2 glottic squamous cell cancers, from May 2017 to March 2020. Patients were grouped according to the extent of TLC: Group I (n = 11, 61.1%): unilateral subepithelial or subligamental cordectomy; Group II (n = 7, 38.9%): unilateral transmuscular, total, or extended cordectomy. Voice quality parameters, including dysphonia grade (G), roughness (R), breathiness (B), maximal phonation time (MPT), jitter, and shimmer, were evaluated before, and at 6 weeks and 6 months after the TLC.

Results: In Group I, the degree of G and R items remained without substantial improvement 6 weeks after surgery; however, improved above the pre-surgery level up to 6 months after surgery. The MPT, jitter, and shimmer did not change significantly at 6 weeks or 6 months post-TLC. In Group II, G, R, and B remained significantly impaired even 6 months post-surgery. Jitter, and shimmer worsened at 6 weeks, but reached preoperative levels at 6 months post-surgery. MPT was significantly worse at 6 weeks and remained deteriorated at 6 months post-surgery. All measured parameters were significantly worse in Group II than in Group I at 6 weeks and 6 months post-surgery. No patient required a phonosurgical procedure.

Conclusion: After a TLC, voice quality evolution depended on the extent of surgery. It did not improve at 6 weeks post-surgery. Improvements in less extent cordectomies occurred between 6 weeks and 6 months post-surgery. Understanding voice development over time is important for counseling patients when considering phonosurgical procedures.

Keywords: Cordectomy; Early glottic cancer; Precancerous laryngeal lesions; Quality of voice; Vocal function.

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Conflict of interest statement

The authors declare that there is no actual or potential conflict of interest in relation to this article. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Figures

Fig. 1
Fig. 1
Evolution of grade, roughness and breathiness in time for Group 1 (upper part) and Group 2 (lower part). 1. Examination—preoperative; 2. examination—6 weeks after surgery; 3. examination—6 months after surgery
Fig. 2
Fig. 2
Changes in the maximum phonation time. Group 1: purple lines; Group 2: orange lines; boxplot shows the median (horizontal line), interquartile range (box), and the maximum and minimum scores
See this image and copyright information in PMC

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