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

2021 ◽  
Author(s):  
Lucia Staníková ◽  
Karol Zeleník ◽  
Martin Formánek ◽  
Jana Seko ◽  
Radana Walderová ◽  
...  
Keyword(s):  
Precancerous Lesions ◽  
Voice Quality ◽  
Quality Parameters ◽  
Substantial Improvement ◽  
Glottic Cancer ◽  
Early Glottic Cancer ◽  
Post Surgery ◽  
Group I ◽  
Group Ii ◽  
Laser Cordectomy

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.

Effectiveness of transoral laser microsurgery for precancerous lesions and early glottic cancer guided by analysis of voice quality

Head & Neck ◽  
2013 ◽  
Vol 36 (6) ◽  
pp. 763-767 ◽  
Author(s):  
Abdulrahman Ali Bahannan ◽  
Aleš Slavíček ◽  
Libor Černý ◽  
Jan Vokřal ◽  
Zdenek Valenta ◽  
...  
Keyword(s):  
Precancerous Lesions ◽  
Voice Quality ◽  
Glottic Cancer ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
Early Glottic Cancer

scholarly journals Multidimensional Voice Quality Evaluation After Transoral CO2 Laser Cordectomy: A Prospective Study

2020 ◽  
Vol 100 (1_suppl) ◽  
pp. 27S-32S
Author(s):  
Yaniv Hamzany ◽  
Lise Crevier-Buchman ◽  
Jérôme R. Lechien ◽  
Gideon Bachar ◽  
Daniel Brasnu ◽  
...  
Keyword(s):  
Voice Quality ◽  
Voice Handicap Index ◽  
Glottic Cancer ◽  
Type I ◽  
Quality Changes ◽  
Early Glottic Cancer ◽  
Maximum Phonation Time ◽  
Group 2 ◽  
Laser Cordectomy ◽  
Group 1

Objective: To investigate voice quality changes of patients treated by transoral laser cordectomy (TLC) for early glottic cancer according to the type of cordectomies. Methods: A total of 164 consecutive male patients with an early glottic cancer were prospectively recruited from the Department of Otolaryngology—Head and Neck Surgery of the Georges Pompidou European Hospital. Depending on the tumor characteristics, patients benefited from type I to VI CO2 cordectomy regarding the European Laryngological Society classification. The following voice quality outcomes were pre- to postoperatively assessed: voice handicap index (VHI), perceptual grade of dysphonia, roughness, breathiness, maximum phonation time, and acoustic parameters. Results: Fifty-five patients with Tis, T1, or T2 vocal fold cancer completed the study (mean age: 61.7 years). Of these patients, 34 and 21 composed group 1 (types I-III TLC) and group 2 (types IV-VI TLC), respectively. Voice handicap index, grade of dysphonia, and breathiness significantly improved from pre- to 3- and 6-month posttreatment in group 1. In group 2, only VHI significantly improved from pre- to 3- and 6-month posttreatment. Acoustic and aerodynamic measurements did not change throughout the postoperative course. Patients with types I to III TLC exhibited better postoperative voice outcomes compared to those treated by types IV to VI TLC. Conclusion: Irrespective to the types of TLC, the subjective voice quality of patients treated by CO2 laser cordectomy for early glottic cancer significantly improved from pre- to 3- and 6-month posttreatment. The usefulness of aerodynamic and acoustic measurements as postoperative outcomes of voice quality changes remain controversial and require future studies considering multidimensional assessment of voice.

A Comparative Effectiveness Evaluation of Percutaneous Adhesiolysis and Epidural Steroid Injections in Managing Lumbar Post Surgery Syndrome: A Randomized, Equivalence Controlled Trial

2009 ◽  
Vol 6;12 (6;12) ◽  
pp. E355-E368
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Facet Joint ◽  
Low Back ◽  
Lumbar Surgery ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Post Surgery ◽  
Group I ◽  
Group Ii ◽  
Epidural Steroid ◽  
Caudal Epidural

Background: Speculated causes of post lumbar surgery syndrome include epidural fibrosis, acquired stenosis, and facet joint pain among other causes. Even though fluoroscopically directed caudal epidural injections and facet joint interventions are effective in some patients, others continue to suffer with chronic persistent pain. Percutaneous adhesiolysis with target delivery of medications has been demonstrated to be effective in these patients. However, the evidence for percutaneous adhesiolysis in managing post surgery syndrome has been questioned, coupled with a paucity of controlled trials. Study Design: A randomized, equivalence, controlled trial. Setting: An interventional pain management practice, a specialty referral center, a private practice setting in the United States. Objectives: To evaluate the effectiveness of percutaneous epidural adhesiolysis in patients with chronic low back and lower extremity pain in post surgery syndrome and compare with fluoroscopically directed caudal epidural steroid injections. Methods: Patients were randomly assigned to one of 2 groups: Group I (60 patients) receiving caudal epidural injections with catheterization up to S3 with local anesthetic, steroids, and 0.9% sodium chloride solution serving as the control group, and Group II (60 patients) receiving percutaneous adhesiolysis with targeted delivery of lidocaine, 10% hypertonic sodium chloride solution, and non-particulate Betamethasone serving as the intervention group. Randomization was performed by computer-generated random allocation sequence by simple randomization. Outcomes Assessment: Multiple outcome measures were utilized including the Numeric Rating Scale (NRS), the Oswestry Disability Index 2.0 (ODI), employment status, and opioid intake with assessment at 3, 6, and 12 months post treatment. Significant pain relief was described as 50% or more, whereas significant improvement in the disability score was defined as a reduction of 40% or more. Results: Significant pain relief (≥ 50%) and functional status improvement was recorded in 73% of patients in Group II versus 12% in Group I (P < 0.001). The average procedures per year were 3.5 with an average total relief of 42 out of 52 weeks in Group II and 2.2 procedures with total relief per year of 13 weeks in Group I (P < 0.001). Limitations: The results of this study are limited by potentially inadequate double blinding, by the lack of a placebo group, and the preliminary report of one-year follow-up. Conclusions: Percutaneous adhesiolysis in chronic function-limiting, recalcitrant low back pain in post lumbar surgery syndrome demonstrated effectiveness in 73% of the patients. Key words: Post lumbar surgery syndrome, post lumbar laminectomy syndrome, chronic low back pain, epidural adhesions, epidural steroid injections, percutaneous adhesiolysis, epidural fibrosis, spinal stenosis, randomized trial, comparative effectiveness

scholarly journals A comparative study between fistulotomy and fistulectomy in management of low anal fistulae

2017 ◽  
Vol 4 (11) ◽  
pp. 3665 ◽  
Author(s):  
Ganesan R. ◽  
Karunakaran K. ◽  
Heber Anandan
Keyword(s):  
Wound Healing ◽  
Operating Time ◽  
Healing Time ◽  
Human Beings ◽  
Fistula In Ano ◽  
Post Surgery ◽  
Group I ◽  
Hospital Stays ◽  
Group Ii ◽  
Wound Healing Time

Background: Fistula in ano is a silent menace in human beings, the treatment is a challenging one even for experienced surgeons, fistula in ano forms a good majority of treatable benign lesions of rectum and anal canal. Aim was to study the efficacy of fistulotomy and fistulectomy in the treatment of low anal fistulae.Methods: A randomized control study was conducted to compare fistulotomy with fistulectomy in patients with low anal fistulae.Results: The operating time in fistulotomy group was 12.13minutes±2.11minutes and in fistulectomy group was 22.23±3.36minutes. The post-surgery hospital stays in Group I was 1.80±0.66days and in Group II was 2.60±0.563 days. The wound healing time in Group I was 24.20±2.95 days which was considerably less when compared to patients in Group II where it was 31.50±4.34 days.Conclusions: Fistulotomy has a slight edge over fistulectomy in the treatment of low anal fistulas since it has shorter operating time, less post-operative pain, less complications, quicker wound healing time, less incontinence and a comparable recurrence rate.

Frozen margin analysis as a prognosis predictor in early glottic cancer by laser cordectomy

2013 ◽  
Vol 123 (6) ◽  
pp. 1490-1495 ◽  
Author(s):  
Tuan-Jen Fang ◽  
Mark S. Courey ◽  
Chun-Ta Liao ◽  
Tsu-Chen Yen ◽  
Hsueh-Yu Li
Keyword(s):  
Glottic Cancer ◽  
Early Glottic Cancer ◽  
Margin Analysis ◽  
Laser Cordectomy

Consequences of voice impairment in daily life for patients following radiotherapy for early glottic cancer: voice quality, vocal function, and vocal performance

1999 ◽  
Vol 44 (5) ◽  
pp. 1071-1078 ◽  
Author(s):  
Irma M Verdonck-de Leeuw ◽  
Ronald B Keus ◽  
Frans J.M Hilgers ◽  
Florien J Koopmans-van Beinum ◽  
An J Greven ◽  
...  
Keyword(s):  
Daily Life ◽  
Voice Quality ◽  
Glottic Cancer ◽  
Vocal Performance ◽  
Early Glottic Cancer ◽  
Vocal Function

scholarly journals Impact of dentures on oral health-related quality of life

2016 ◽  
Vol 69 (7-8) ◽  
pp. 203-211 ◽  
Author(s):  
Sanja Gnjato
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Research Study ◽  
Life Quality ◽  
Quality Parameters ◽  
Group Iii ◽  
Group I ◽  
Health Quality ◽  
Group Ii

Introduction. Stomatoprothetic dentures are one of the factors of oral health and life quality of people of all ages. The aim of the paper is to make a connection between the oral health quality and quality of life on one side and the type of denture on the other. Material and Methods. This research study was conducted on the sample of 360 patients singled out in three numerically identical groups as follows: group I - patients treated with fixed dentures, group II - patients treated with mobile dentures, and group III - patients treated with both fixed and mobile dentures. The oral health quality was observed via five parameters: anamnestic data, symptoms of ill-functioning of basic functions in stomatogenic system (chewing and speech), extra oral examination, intraoral examination, and dental abilities. For some oral health quality parameters, the index of quality was determined. Results. Analyses of our three target groups of patients indicated that the patients from group I (treated with fixed dentures) suffered the least negative effects in line with the observed parameters; they are followed by patients from group III (combined dentures) and patients from group II (mobile dentures), respectively. Conclusion. Our research study showed that some oral health parameters have different impacts on health and life quality in patients treated with different stomatoprosthetic dentures.

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