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.

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.

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.

Assessment of Early Stage Glottic Cancer Depth of Resection After Transoral Laser Cordectomy

2021 ◽  
pp. 019459982110376
Author(s):  
Jacob T. Cohen ◽  
Tal Goldman ◽  
Miki Paker ◽  
Eran Fridman
Keyword(s):  
Early Stage ◽  
Staining Technique ◽  
Collagen I ◽  
Glottic Cancer ◽  
Type I ◽  
Tertiary Referral Hospital ◽  
Early Glottic Cancer ◽  
Immunohistochemistry Stain ◽  
Picrosirius Red ◽  
Laser Cordectomy

Objective Surgeons generally determine depth of resection during transoral laser cordectomy by visual inspection of the surgical field. Our aim was to examine the correlation between early glottic cancer depth of resection as reported by surgeons in the operation report and depth of resection defined by pathology specimens, using various staining techniques intended to differentiate between the distinct vocal fold layers based on particular collagen deposition. Study Design Retrospective study. Setting A voice and swallowing clinic at a tertiary referral hospital. Methods We compared depth of cordectomy assessed intraoperatively by surgeons and by pathologists using Picrosirius red stain and collagen I immunohistochemistry stain in 32 patients who underwent transoral laser cordectomy for early glottic cancer. Results For type I, II, and III cordectomy, the respective proportions of patients were 14 (47%), 9 (30%), and 7 (23%) according to surgeons’ estimations; 2 (6%), 17 (55%), and 12 (39%) according to Picrosirius red stain; and 3 (11%), 12 (44%), and 12 (45%) according to immunohistochemistry for collagen I. Conclusion Surgeons’ reported depth of resection did not correlate with depth of resection established by either staining technique. Determining depth of resection necessitates special stains, which should help in the clinical assessment of cordectomy type.

scholarly journals Voice quality after endoscopic laser surgery and radiotherapy for early glottic cancer: objective measurements emphasizing the Voice Handicap Index

2007 ◽  
Vol 265 (5) ◽  
pp. 543-548 ◽  
Author(s):  
Faustino Núñez Batalla ◽  
Maria Jesús Caminero Cueva ◽  
Blanca Señaris González ◽  
José Luis Llorente Pendás ◽  
Carmen Gorriz Gil ◽  
...  
Keyword(s):  
Laser Surgery ◽  
Voice Quality ◽  
Voice Handicap Index ◽  
Glottic Cancer ◽  
Early Glottic Cancer ◽  
Objective Measurements ◽  
Endoscopic Laser ◽  
The Voice ◽  
Endoscopic Laser Surgery

scholarly journals Factors affecting voice quality in early glottic cancer before and after radiotherapy

2019 ◽  
Vol 53 (4) ◽  
pp. 459-464 ◽  
Author(s):  
Jana Mekis ◽  
Primoz Strojan ◽  
Irena Hocevar Boltezar
Keyword(s):  
Anterior Commissure ◽  
Voice Quality ◽  
Vocal Folds ◽  
Medical Documentation ◽  
Glottic Cancer ◽  
Glottic Carcinoma ◽  
Early Glottic Cancer ◽  
Factors Affecting ◽  
Maximum Phonation Time ◽  
Multimodal Methods

Abstract Background Radiotherapy (RT) is a successful mode of treatment for early glottic cancer. The aim of the study was to assess voice quality both before and 3 months after successful RT using multimodal methods while also identifying the factors affecting it. Patients and methods In 50 patients with T1 glottic carcinoma, the subjective (patients’ assessment of voice quality [VAS], Voice Handicap Index [VHI] questionnaire, phoniatricians’ assessment using the grade/roughness/ breathiness [GRB] scale), and objective assessments (fundamental laryngeal frequency [F0], jitter, shimmer, maximum phonation time [MPT]) of voice quality were performed before RT and 3 months post-RT. The data on gender, age, extent of the tumors, biopsy types, smoking, local findings, and RT were obtained from the medical documentation. Results Three months after the treatment, VAS, VHI, G and R scores, F0, and MPT significantly improved in comparison with their assessment prior to treatment. Before the treatment, the involvement of the anterior commissure significantly deteriorated jitter (p = 0.044) and the involvement of both vocal folds deteriorated jitter (p = 0.003) and shimmer (p = 0.007). After the RT, F0 was significantly higher in the patients with repeated biopsy than in the others (p = 0.047). In patients with post-RT changes, the B score was significantly higher than in those without post-RT changes (p = 0.029). Conclusions Voice quality already significantly improved three months after the treatment of glottic cancer. The main reason for the decreased voice quality prior to treatment is the tumor’s extent. Post-RT laryngeal changes and repeated biopsies caused more scarring on vocal folds adversely influencing voice quality after the treatment.

scholarly journals Anti-MDA5 juvenile idiopathic inflammatory myopathy: a specific subgroup defined by differentially enhanced interferon-α signalling

Rheumatology ◽  
2019 ◽  
Vol 59 (8) ◽  
pp. 1927-1937 ◽  
Author(s):  
Isabelle Melki ◽  
Hervé Devilliers ◽  
Cyril Gitiaux ◽  
Vincent Bondet ◽  
Darragh Duffy ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Interferon Α ◽  
Type I ◽  
Group 2 ◽  
Skin Ulcerations ◽  
Overlap Myositis ◽  
Group 1

Abstract Objectives JDM and juvenile overlap myositis represent heterogeneous subtypes of juvenile idiopathic inflammatory myopathy (JIIM). Chronic evolution can occur in up to 60% of cases, and morbidity/mortality is substantial. We aimed to describe the clinical, biological, histological and type I IFN status in JIIM associated with anti-melanoma differentiation-associated protein 5 (anti-MDA5) autoantibodies at presentation (group 1) in comparison with other JIIM (group 2). Methods This was a retrospective and prospective study of patients with JIIM ascertained from three French paediatric rheumatology reference centres between 2013 and 2019. Muscle biopsies were reviewed. Type I interferon pathway activity was assessed by dosage of IFNα serum protein and the expression of IFN-stimulated genes. Results Sixty-four patients were included, 13 in group 1 (54% JDM and 46% juvenile overlap myositis) and 51 in group 2 (76% JDM and 24% juvenile overlap myositis). Group 1 patients demonstrated more arthritis, skin ulcerations, lupus features and interstitial lung disease, and a milder muscular involvement. Serum IFNα levels were higher in group 1 than 2, and decreased after treatment or improvement in both groups. Outcome was similar in both groups. Unconventional treatment (more than two lines) was required in order to achieve remission, especially when skin ulceration was reported. Conclusion This study indicates a higher frequency of arthritis, skin ulcerations and interstitial lung disease, but milder muscular involvement, in JIIM with positive anti-MDA5 autoantibodies compared with other JIIM. Our data support an important role of systemic IFNα in disease pathology, particularly in the anti-MDA5 auto-antibody-positive subgroup. In severe and refractory forms of JIIM, IFNα may represent a therapeutic target.

Longitudinal analysis of Voice Handicap Index in early glottic cancer patients treated with transoral laser microsurgery: age, gender, stage and time dependence

2019 ◽  
Vol 133 (4) ◽  
pp. 318-323 ◽  
Author(s):  
C Lane ◽  
M Rigby ◽  
R Hart ◽  
J Trites ◽  
E Levi ◽  
...  
Keyword(s):  
Voice Handicap Index ◽  
Glottic Cancer ◽  
Glottic Carcinoma ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
Early Glottic Cancer ◽  
Related Quality ◽  
The Voice

AbstractObjectivesTransoral laser microsurgery is an increasingly common treatment modality for glottic carcinoma. This study aimed to determine the effect of age, gender, stage and time on voice-related quality of life using the Voice Handicap Index-10.MethodsPrimary early glottic carcinoma patients treated with transoral laser microsurgery were included in the study. Self-reported Voice Handicap Index testing was completed pre-operatively, three months post-operatively, and yearly at follow-up appointments.ResultsVoice Handicap Index improvement was found to be dependent on age and tumour stage, while no significant differences were found in Voice Handicap Index for gender. Voice Handicap Index score was significantly improved at 12 months and 24 months. Time versus Voice Handicap Index modelling revealed a preference for non-linear over linear regression.ConclusionAge and stage are important factors, as younger patients with more advanced tumours show greater voice improvement post-operatively. Patient's Voice Handicap Index is predicted to have 95 per cent of maximal improvement by 5.5 months post-operatively.

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
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