Surgical Voice Rehabilitation after Laser Surgery for Glottic Carcinoma

2002 ◽  
Vol 111 (6) ◽  
pp. 493-499 ◽  
Author(s):  
Christian Sittel ◽  
Patrick Zorowka ◽  
Gerhard Friedrich ◽  
Hans-Edmund Eckel
Keyword(s):  
Laser Surgery ◽  
Thyroid Cartilage ◽  
Voice Quality ◽  
Scar Tissue ◽  
Voice Rehabilitation ◽  
Special Technique ◽  
Glottic Carcinoma ◽  
Vocal Rehabilitation ◽  
Medialization Thyroplasty ◽  
Patient’S Perception

Transoral laser surgery today is the mainstay of treatment for T1 and T2 glottic carcinoma. The vocal ability remains sufficient in the majority of patients. However, in some cases, a significant glottic gap may persist, leading to poor voice quality. We report a special technique of medialization thyroplasty using autologous cartilage specifically adapted for vocal rehabilitation after laser resection. Six patients with a significant glottic gap following laser surgery were treated. For vocal rehabilitation, a special medialization technique was performed. The superior rim of the thyroid cartilage of the resected side was exposed. A 1 × 2-cm piece of cartilage was harvested and reimplanted into a subperichondrial pouch created on the inner side of the thyroid cartilage. When phonation was optimal, this cartilaginous strut was sutured and/or glued in place. In all 6 cases, the vocal function improved significantly. The dysphonia index (0 = normal, 3 = aphonia), which includes objective parameters as well as expert voice ratings and the patient's perception, increased by 1.1 on average (range, 0.4 to 1.6). The results have been lasting. The established medialization techniques are of limited value in a larynx scarred by laser surgery. Injection augmentation is often futile because the tight scar tissue does not lend itself to augmentation. Implantation of nonorganic material may cause problems if revision surgery for tumor recurrence should become necessary or if the implant protrudes into the scarred endolarynx. The technique reported avoids these pitfalls and leads to voice quality improvement comparable to that of established medialization procedures.

S179 – Voice Self-evaluation after Treatment for T1 Glottic Cancer

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P136-P136
Author(s):  
Faustino Nunez ◽  
Maria Jesus Caminero ◽  
Jose-Luis Llorente-Pendas ◽  
Carlos Suarez-Nieto
Keyword(s):  
Laser Surgery ◽  
Voice Quality ◽  
Well Being ◽  
Voice Handicap Index ◽  
Glottic Cancer ◽  
Glottic Carcinoma ◽  
Subjective Analysis ◽  
Maximum Phonation Time ◽  
Self Evaluation ◽  
The Voice

Objectives 1) To present the objective and subjective analysis of voice quality following treatment of an early epidermoid glottic carcinoma. 2) Results from the objective evaluation of the voice, along with the self-evaluation of voice quality quantified using the Voice Handicap Index of a group of patients treated with endoscopic laser surgery, are compared with patients treated with radiotherapy. Methods We performed an objective voice evaluation, as well as a physical, emotional, and functional well-being assessment of 19 patients treated with laser surgery and 18 patients treated with radiotherapy. The data obtained was gathered in the statistical database SPSS 12.0. The statistical analysis used was the “Student t test” in order to compare averages and the Chi-squared test for comparing proportions. The statistical differences were considered significant when p was lower than 0.05. Results Voice quality is affected both by surgery and radiotherapy. Voice parameters only show differences in the maximum phonation time between both treatments (p < 0,005). Patients Self-Perception Analysis (Voice Handicap Index) Upon completing the comparison between the two groups, the statistical difference is significant, in favor of the radiotherapy patients in functional and emotional ratings, as well as the global scores (p < 0,005). No significant differences were found in the physical scales. Conclusions There is a reduced impact in patient's perception of voice quality after radiotherapy, despite no significant differences in vocal quality between radiotherapy and laser cordectomy.

Medialization thyroplasty in glottis insufficiency due to unilateral vocal fold paralysis and after laser cordectomies – preliminary report

2017 ◽  
Vol 71 (1) ◽  
pp. 22-29
Author(s):  
Anna Rzepakowska ◽  
Ewa Osuch-Wójcikiewicz ◽  
Ewelina Sielska-Badurek ◽  
Kazimierz Niemczyk
Keyword(s):  
Vocal Fold ◽  
Acoustic Analysis ◽  
Standard Procedure ◽  
Thyroid Cartilage ◽  
Voice Quality ◽  
Type I ◽  
Vocal Fold Paresis ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation ◽  
Medialization Thyroplasty

Medialization thyroplasty (type I) is surgical procedure performed on the thyroid cartilage. The major indication for this surgery is significant glottis insufficiency due to unilateral vocal fold paresis. However the proce¬dure is also performed after vocal fold resections during cordectomy. The aim: The evaluation of voice results in patients after medialisation throplasty. Material and methods: In Otolaryngology Department of Medical University of Warsaw there were performed so far 8 thyroplasty procedures under local anaesthesia with implantation of medical silicon protesis. 6 patients had unilat¬eral vocal fold paresis and the rest two underwent in the past laser cordectomy due to T1a vocal carcinoma. Results: There were no complications during and post the surgery. The follow up examination in 1st , 3rd, 6th i 12th months postoperatively revealed for all patients significant improvement of glottal closure in laryngeal videostrobos¬copy. The voice quality improved both in perceptual evaluation (GRBAS scale) and acoustic analysis (F0, jitter, shim¬mer, NHR) in both patients groups. However the rate of improvement was much more significant in group with uni¬lateral vocal fold paresis. In all patients the maximum phonation time (MPT) increased. The self-evaluation of voice quality with Voice Handicap Index questionnaire confirmed also individual improvement. Conclusions: The speech rehabilitations is not successful in each patient with glottis insufficiency. The medialisation thyroplasty remains the standard procedure for permanent improvement of voice quality in those cases.

scholarly journals The voice quality after laser surgery versus radiotherapy of T1a glottic carcinoma: systematic review and meta-analysis

2017 ◽  
Vol Volume 10 ◽  
pp. 2403-2410 ◽  
Author(s):  
Guanjiang Huang ◽  
Mengsi Luo ◽  
Jingxuan Zhang ◽  
Hongbing Liu
Keyword(s):  
Systematic Review ◽  
Laser Surgery ◽  
Meta Analysis ◽  
Voice Quality ◽  
Glottic Carcinoma ◽  
The Voice

Voice Quality After Laser Surgery or Radiotherapy for T1a Glottic Carcinoma

2003 ◽  
Vol 113 (5) ◽  
pp. 910-914 ◽  
Author(s):  
Etsuyo Tamura ◽  
Satoshi Kitahara ◽  
Masami Ogura ◽  
Naoyuki Kohno
Keyword(s):  
Laser Surgery ◽  
Voice Quality ◽  
Glottic Carcinoma

Curative Radiotherapy for Anterior Commissure Laryngeal Carcinoma

2000 ◽  
Vol 109 (2) ◽  
pp. 156-159 ◽  
Author(s):  
Mark S. Persky ◽  
Victor M. Lagmay ◽  
Minas Constantinides ◽  
Jay Cooper ◽  
Robert O'Leary
Keyword(s):  
Early Stage ◽  
Anterior Commissure ◽  
Thyroid Cartilage ◽  
Voice Quality ◽  
Glottic Carcinoma ◽  
T2 Lesions ◽  
Curative Radiotherapy ◽  
Early Tumor ◽  
Standard Fractionation

There is continuing controversy surrounding the most effective treatment of glottic carcinoma involving the anterior commissure (AC). Surgery has been the preferred method of treatment, since studies previously indicated early tumor invasion of the thyroid cartilage at the AC, thereby assuming less curability by radiotherapy (RT). Subsequent laryngeal anatomic studies and refinement of RT techniques have brought into question the ineffectiveness of curative irradiation. A retrospective review of 174 patients with early-stage glottic carcinoma treated with standard fractionation curative RT revealed 34 patients with T1 and T2 lesions involving the AC. Allowing for a follow-up of at least 3 years, we observed only a 12% (4 of 34 patients) local recurrence rate after RT alone, with excellent voice quality and no major complications related to the irradiation. The 4 local recurrences were controlled by total laryngectomy, although 2 patients developed distant metastatic disease. Radiotherapy represents an effective method of treating T1 squamous cell carcinoma of the glottis with AC involvement. The small number of T2 glottic carcinomas in this study prevents a meaningful conclusion concerning treatment of these lesions.

Voice quality after carbon dioxide laser and conventional surgery for T1A glottic carcinoma

2004 ◽  
Vol 18 (4) ◽  
pp. 545-550 ◽  
Author(s):  
Antonio Schindler ◽  
Francesca Palonta ◽  
Giuliana Preti ◽  
Francesco Ottaviani ◽  
Oskar Schindler ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Carbon Dioxide Laser ◽  
Voice Quality ◽  
Glottic Carcinoma ◽  
Conventional Surgery

Telehealth

2003 ◽  
Vol 12 (4) ◽  
pp. 432-439 ◽  
Author(s):  
Pauline A. Mashima ◽  
Deborah P. Birkmire-Peters ◽  
Mark J. Syms ◽  
Michael R. Holtel ◽  
Lawrence P. A. Burgess ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Underserved Populations ◽  
Voice Quality ◽  
Video Camera ◽  
Conventional Group ◽  
Vocal Rehabilitation ◽  
Rehabilitation Protocol ◽  
Perceptual Judgments ◽  
Vocal Hyperfunction ◽  
Vocal Nodules

Telehealth offers the potential to meet the needs of underserved populations in remote regions. The purpose of this study was a proof-of-concept to determine whether voice therapy can be delivered effectively remotely. Treatment outcomes were evaluated for a vocal rehabilitation protocol delivered under 2 conditions: with the patient and clinician interacting within the same room (conventional group) and with the patient and clinician in separate rooms, interacting in real time via a hard-wired video camera and monitor (video teleconference group). Seventy-two patients with voice disorders served as participants. Based on evaluation by otolaryngologists, 31 participants were diagnosed with vocal nodules, 29 were diagnosed with edema, 9 were diagnosed with unilateral vocal fold paralysis, and 3 presented with vocal hyperfunction with no laryngeal pathology. Fifty-one participants (71%) completed the vocal rehabilitation protocol. Outcome measures included perceptual judgments of voice quality, acoustic analyses of voice, patient satisfaction ratings, and fiber-optic laryngoscopy. There were no differences in outcome measures between the conventional group and the remote video teleconference group. Participants in both groups showed positive changes on all outcome measures after completing the vocal rehabilitation protocol. Reasons for participants discontinuing therapy prematurely provided support for the telehealth model of service delivery.

Predictive Factors of Carcinological Outcomes for Glottic Cancer Treated With Transoral Laser Cordectomy

2020 ◽  
Vol 2 (1) ◽  
pp. 01-04
Author(s):  
ALJ zineb
Keyword(s):  
Predictive Factors ◽  
Laser Surgery ◽  
Local Control Rate ◽  
Glottic Cancer ◽  
Glottic Carcinoma ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Early Glottic Cancer ◽  
Transoral Laser Surgery ◽  
Preservation Rate

Tran’s oral laser surgery is at the forefront of the therapeutic arsenal of epidermoid glottic cancer, but its indications for certain local extensions are controversial. We have analyzed through a retrospective study of 37 patients with T1 or T2 epidermoid glottic carcinoma, treated with transoral laser surgery, the post-surgical outcomes regarding the relapse-free survival, local control rate, laryngeal preservation rate and overall survival, correlated to the initial local extension. This study aimed at clarifying further the clinical behavior of early glottic cancer following transoral laser surgery and to determine, using retrospective analysis, and the predictive factors of carcinological outcomes.

Laser Surgery for T2 Glottic Carcinoma

2002 ◽  
Vol 12 (1) ◽  
pp. 36-41 ◽  
Author(s):  
J.A. Werner ◽  
A.A. Dünne ◽  
B.J. Folz ◽  
B.M. Lippert
Keyword(s):  
Laser Surgery ◽  
Glottic Carcinoma
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