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Lechien JR, Hans S, Crevier-Buchman L. Influence of age on voice quality after transoral CO 2 laser microsurgery. J Otolaryngol Head Neck Surg 2023; 52:59. [PMID: 37697412 PMCID: PMC10496204 DOI: 10.1186/s40463-023-00664-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 08/28/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVE To study the post-operative evolution of voice quality of patients treated by transoral CO2 laser microsurgery (TLM) according to the age. METHODS Patients treated by type I to VI TLM and post-operative speech therapy were prospectively recruited from our hospital. The voice quality was assessed pre-, 1-, 3- 6- and 12-month posttreatment with voice handicap index (VHI), dysphonia, roughness, breathiness, asthenia, strain (GRBAS), maximal phonation time (MPT), F0, F0 standard deviation (STD), percent jitter, percent shimmer, noise-to-harmonic ratio (NHR), vocal fold vibration assessment and speech fluency. Evolution of voice outcomes was analyzed considering age of patients (< 60 vs. ≥ 60 years). RESULTS Seventy-five patients completed the evaluations. Thirty-four and forty-one patients were < 60 or ≥ 60 yo, respectively. Subjective and objective voice parameters (VHI, G, R, B), jitter and fluency significantly improved from 1- to 6-month post-TLM in < 60 yo individuals. The voice parameters improved 12-month post-TLM in the ≥ 60 yo group at the exception of VHI that improved 3-month post-TLM. There were positive associations between age and 12-month NHR, G and A parameters. CONCLUSION The post-operative evolution of voice quality parameters may vary between patients according to the age. Preoperative VHI is predictive of 12-month subjective and objective voice outcomes.
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Affiliation(s)
- Jerome R Lechien
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
- Department of Otolaryngology-Head & Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, Brussels, Belgium.
- Department of Otolaryngology, Polyclinic of Poitiers, Elsan Hospital, Poitiers, France.
- Faculty of Medicine, Department of Human Anatomy and Experimental Oncology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
- Phonetics and Phonology Lab, CNRS UMR7018, Univ. Sorbonne University, Paris, France.
| | - Stephane Hans
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
- Phonetics and Phonology Lab, CNRS UMR7018, Univ. Sorbonne University, Paris, France
| | - Lise Crevier-Buchman
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
- Phonetics and Phonology Lab, CNRS UMR7018, Univ. Sorbonne University, Paris, France
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Öztürk K, Turhal G, Şahin FF, Sezgin B. The Comparison of Electroacoustic and Subjective Voice Quality in Type 3 and 4 Transoral Laser Cordectomy for Early-Stage Glottic Carcinoma. Indian J Otolaryngol Head Neck Surg 2023; 75:680-684. [PMID: 37275100 PMCID: PMC10235358 DOI: 10.1007/s12070-022-03342-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/30/2022] [Indexed: 12/31/2022] Open
Abstract
One of the main issues in early-stage glottic carcinoma management is the voice quality following different types of treatment modalities. In type 3 and 4 transoral laser cordectomies, the voice outcomes can show significant differences due to the extent of the vocal muscle resection. This study aims to compare the voice quality in patients who underwent type 3 and 4 laser cordectomy for early-stage glottic carcinoma. A total of 30 patients who underwent type 3 (15 patients) and type 4 (15 patients) laser cordectomy for T1a glottic carcinoma between May 2018 and 2020 were included in this retrospective comparative study. Electroacoustic voice analysis and Voice Handicap Index-10 were performed in the postoperative twelfth month and the outcomes were compared between two laser cordectomy groups. The mean age of all patients was 48.6 ± 4.2 years. Noise-to-harmonic ratio, jitter, shimmer, pitch perturbation quotient and amplitude perturbation quotient values were significantly different between two groups (p < 0.05). Fundamental frequency and Voice Handicap Index-10 scores showed no statistically significant difference (p > 0.05). This study reports significantly better results for type 3 against type 4 laser cordectomy by means of objective voice analysis outcomes, except fundamental frequency. On the other hand, self-reported subjective analysis showed very similar results for both groups. Further studies combining data with multiple objective and subjective analyses with larger patient series and longer follow-up are warranted.
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Affiliation(s)
- Kerem Öztürk
- Department of Otorhinolaryngology, Ege University School of Medicine, Izmir, Turkey
| | - Göksel Turhal
- Department of Otorhinolaryngology, Ege University School of Medicine, Izmir, Turkey
| | - Fetih Furkan Şahin
- Department of Otorhinolaryngology, Kiziltepe State Hospital, 47400 Mardin, Turkey
| | - Baha Sezgin
- Otorhinolaryngology, Private Practice, Izmir, Turkey
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3
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Lechien JR, Crevier-Buchman L, Circiu MP, De Mones E, de Pemille GV, Julien-Laferriere A, Saussez S, Baudouin R, Remacle M, Hans S. Voice Quality Outcomes After Transoral CO 2 Laser Cordectomy: A Longitudinal Prospective Study. Otolaryngol Head Neck Surg 2023; 168:422-428. [PMID: 35998041 DOI: 10.1177/01945998221114762] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/29/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the evolution of voice quality in patients after type I-VI transoral CO2 laser cordectomy (TLC) by using validated voice outcome measures over a 12-month period. STUDY DESIGN Prospective uncontrolled study. SETTING Monocenter study. METHODS Patients with laryngeal carcinoma who were eligible for type I-IV TLC were prospectively recruited from a tertiary medical center. The following outcomes were assessed throughout the 12-month posttreatment period: Voice Handicap Index (VHI), GRBAS (grade of dysphonia, roughness, breathiness, asthenia, strain), maximal phonation time, fundamental frequency (F0), F0 standard deviation, percentage jitter, percentage shimmer, noise-to-harmonic ratio, and speech fluency. Analyses were performed considering 2 groups of cordectomies: type I-III vs IV-VI. RESULTS A total of 131 patients completed the evaluations, totaling 76 type I-III and 55 type IV-VI cordectomies. In type IV-VI, breathiness and maximal phonation time significantly worsened from pretreatment to 1 month posttreatment (P < .05). In the type I-III cordectomy group, VHI, shimmer, roughness, breathiness, and strain significantly improved from pretreatment to 3 months posttreatment, while VHI, F0 standard deviation, shimmer, jitter, grade of dysphonia, roughness, breathiness, and strain improved from baseline to 6 months. Assessments at 12 months posttreatment revealed significant improvements for VHI, shimmer, jitter, noise-to-harmonic ratio, grade of dysphonia, roughness, breathiness, and strain. In the type IV-VI group, VHI significantly improved from baseline to 3, 6, and 12 months posttreatment. Strain improved at 6 and 12 months while roughness improved from baseline to 12 months. Maximal phonation time significantly worsened over the 12-month evaluation period. CONCLUSION The effect of TLC on voice quality depends on its type. VHI was identified as the most indicative tool of voice changes irrespective of TLC type.
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Affiliation(s)
- Jerome R Lechien
- Department of Otolaryngology, Elsan Hospital, Paris, France
- Department of Otolaryngology-Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, Brussels, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium
| | - Lise Crevier-Buchman
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
- Phonetics and Phonology Lab, CNRS UMR7018, Sorbonne University, Paris, France
| | - Marta P Circiu
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Erwan De Mones
- Department of Otolaryngology-Head and Neck Surgery, Pellegrin Hospital, University Hospital, CHU Bordeaux, Bordeaux, France
| | - Grégoire Vialatte de Pemille
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Aude Julien-Laferriere
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Sven Saussez
- Department of Otolaryngology-Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, Brussels, Belgium
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium
| | - Robin Baudouin
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Marc Remacle
- Department of Otolaryngology-Head and Neck Surgery, Eich Luxembourg Hospital, Luxembourg, Luxembourg
| | - Stephane Hans
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
- Phonetics and Phonology Lab, CNRS UMR7018, Sorbonne University, Paris, France
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Colizza A, Ralli M, D'Elia C, Greco A, de Vincentiis M. Voice quality after transoral CO 2 laser microsurgery (TOLMS): systematic review of literature. Eur Arch Otorhinolaryngol 2022; 279:4247-4255. [PMID: 35505113 PMCID: PMC9363323 DOI: 10.1007/s00405-022-07418-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/20/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Transoral laser microsurgery (TOLMS) with carbon dioxide is a safe approach for laryngeal carcinoma. In literature there are three main methods for evaluating speech outcomes: acoustic and aerodynamics analysis, perceptual evaluation and patient-reported outcomes (PROs). The aim of this study was to systematically review the literature about the voice quality outcomes of TOLMS according to type of cordectomy. METHODS A systematic literature review was performed and all the results until December 2021 were extrapolated. We evaluated the acoustic and aerodynamics parameters (fundamental frequency, harmonics to noise ratio, jitter, shimmer and maximum phonation time), perceptual data (GRBAS scale) and patient-related outcomes (VHI scale). RESULTS 24 studies met the inclusion criteria for a total number of 1207 patients enrolled. The number for each type of cordectomy are: 287 type I (23.78%), 311 type II (25.78%), 328 type III (27.14%), 129 type 4 (10.69%) and 152 type V (12.60%). Patients are grouped according to the type of cordectomy in: limited cordectomy (type I and II) and extended cordectomy (types III-IV-V). The difference between two groups is statistically significative in terms of acoustic analysis, perceptual data and patient-related outcomes (p < 0.05). CONCLUSIONS Patients who underwent type I or II cordectomy have significantly better quality of voice in terms of VHI, perceptual voice quality evaluations and acoustic parameters compared to type III, IV and V cordectomies. The effect of TOLMS on the voice should depend from the extent of the resection and in particular from the scar of the vocal muscle.
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Affiliation(s)
- Andrea Colizza
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy.
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Chiara D'Elia
- Otorhinolaryngology Unit, Policlinico Umberto I, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
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Sjogren E, Hendriksma M, Piazza C, Hartl DM, Suarez C, Cohen O, de Bree R, Quer M, Poorten VV, Rodrigo JP, Civantos F, Genden E, Kowalski LP, Makitie A, Shaha A, Takes RP, Sanabria A, Guntinas-Lichius O, Rinaldo A, Ferlito A. Voice Outcome After Carbon Dioxide Transoral Laser Microsurgery for Glottic Cancer According to the European Laryngological Society Classification of Cordectomy Types - A Systematic Review. J Voice 2022:S0892-1997(22)00069-8. [PMID: 35422356 DOI: 10.1016/j.jvoice.2022.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/06/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Voice outcome after carbon dioxide transoral laser microsurgery (CO2TOLMS) for glottic cancer is of prime importance. However, a comprehensive overview according to the European Laryngological Society (ELS) classification of cordectomies is still lacking. The aim of this systematic review is to summarize data on voice outcome associated with individual types of ELS glottic cordectomy after CO2TOLMS. MATERIALS AND METHODS A systematic review of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The initial search identified 936 records of which 25 publications were then included. Voice outcome data (Voice Handicap Index [VHI] version 30, grade of dysphonia [G] and maximum phonation time [MPT]) were extracted per resection type. Weighted averages were calculated. RESULTS Data show a gradual increase in the VHI scores although they were still similar for all cordectomy types (range 14.2 to 21.5). The grade of dysphonia showed a gradual increase with increasing resection depth (range 1.0 to 1.9). There was a gradual decrease in the MPT (range 15.2 to 7.2). CONCLUSION Voice outcome is related to cordectomy type with mild dysphonia characterizing ELS type I, II and III cordectomies, while more extended cordectomies (ELS type IV, V and VI) result in moderate dysphonia and shortness of breath during phonation. The voice handicap experienced by patients is limited even in the more extended cordectomies.
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Affiliation(s)
- Elisabeth Sjogren
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.
| | - Martine Hendriksma
- Department of Otorhinolaryngology, Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Cesare Piazza
- Department of Otorhinolaryngology- Head and Neck Surgery, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Dana M Hartl
- Department of Otolaryngology Head and Neck Surgery, Institut Gustave Roussy and University Paris-Sud, Villejuif Cedex, France
| | - Carlos Suarez
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Oded Cohen
- Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Miquel Quer
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Vincent Vander Poorten
- Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium; Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Juan Pablo Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, IUOPA, University of Oviedo, Centro de Investigación Biomédica en Red de Cancer (CIBERONC), Oviedo, Spain
| | - Francisco Civantos
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida
| | - Eric Genden
- Ear, Nose, Throat / Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Luiz P Kowalski
- Head and Neck Surgery and Otorhinolarynglology Department, A C Camargo Cancer Center, and Head and Neck Surgery Department, University of São Paulo Medical School
| | - Antti Makitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ashok Shaha
- Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia/Hospital Universitario San Vicente Fundación, Medellín, Colombia.; CEXCA Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellín, Colombia
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Jena, Germany
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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Lechien JR, Crevier-Buchman L, Circiu MP, Lisan Q, Hans S. Evolution of Voice Quality in Type 1-2 Transoral CO 2 Laser Cordectomy: A Prospective Comparative Study. Laryngoscope 2021; 132:1421-1426. [PMID: 34704611 DOI: 10.1002/lary.29924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS To compare the 12-month evolution of voice quality outcomes in patients who benefited from types 1-2 transoral CO2 laser cordectomy (TLC) for an early-stage vocal fold squamous cell carcinoma (VFSCC). STUDY DESIGN Prospective uncontrolled study. METHODS Sixty patients with cT1 VFSCC were consecutively recruited from a single medical center. Thirty patients benefited from type 1 TLC, while type 2 TCL was performed in 30 patients. The following voice quality outcomes were evaluated at baseline, 3-, 6-, and 12-month post-TLC: voice handicap index (VHI), GRBAS, speech rate, maximum phonation time (MPT), and acoustic parameters. Voice quality evolution was compared between type 1 and type 2 TLC. RESULTS Fifty-seven patients completed the evaluations. Type 1 TLC patients reported significant improvements of VHI, grade of dysphonia, and breathiness at 3-, 6-, and 12-month post-TLC. Speech rate and jitter values improved 6- and 12-month post-TLC. A few voice quality outcomes reported 3- or 6-month post-TLC improvements in type 2 TLC group, while VHI, grade of dysphonia improved at 6- and 12-month post-TLC. MPT significantly decreased at 6- and 12-month post-TLC, while there were no acoustic measurement changes in type 2 TLC. CONCLUSIONS The effect of TLC on voice quality may depend on the type of TLC. Type 1 TLC was associated with faster voice quality improvements compared with type 2 TLC. VHI and dysphonia grade were identified as the most relevant tool of voice changes irrespective to the TLC type. LEVEL OF EVIDENCE 3 Laryngoscope, 2021.
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Affiliation(s)
- Jerome R Lechien
- Department of Otolaryngology, Elsan Hospital, Paris, France.,Department of Otorhinolaryngology-Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Brussels, Belgium.,Department of Otorhinolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, Paris Saclay University, Paris, France
| | - Lise Crevier-Buchman
- Department of Otorhinolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, Paris Saclay University, Paris, France.,Phonetics and Phonology Lab, CNRS UMR7018, University of Sorbonne-Nouvelle, Paris, France
| | - Marta P Circiu
- Department of Otorhinolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, Paris Saclay University, Paris, France
| | - Quentin Lisan
- Department of Otorhinolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, Paris Saclay University, Paris, France
| | - Stephane Hans
- Department of Otorhinolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, Paris Saclay University, Paris, France.,Phonetics and Phonology Lab, CNRS UMR7018, University of Sorbonne-Nouvelle, Paris, France
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T1a Glottic Cancer: Advances in Vocal Outcome Assessment after Transoral CO 2-Laser Microsurgery Using the VEM. J Clin Med 2021; 10:jcm10061250. [PMID: 33802971 PMCID: PMC8002749 DOI: 10.3390/jcm10061250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/10/2021] [Accepted: 03/15/2021] [Indexed: 12/18/2022] Open
Abstract
Patients with unilateral vocal fold cancer (T1a) have a favorable prognosis. In addition to the oncological results of CO2 transoral laser microsurgery (TOLMS), voice function is among the outcome measures. Previous early glottic cancer studies have reported voice function in patients grouped into combined T stages (Tis, T1, T2) and merged cordectomy types (lesser- vs. larger-extent cordectomies). Some authors have questioned the value of objective vocal parameters. Therefore, the purpose of this exploratory prospective study was to investigate TOLMS-associated oncological and vocal outcomes in 60 T1a patients, applying the ELS protocols for cordectomy classification and voice assessment. Pre- and postoperative voice function analysis included: Vocal Extent Measure (VEM), Dysphonia Severity Index (DSI), auditory-perceptual assessment (GRB), and 9-item Voice Handicap Index (VHI-9i). Altogether, 51 subjects (43 male, eight female, mean age 65 years) completed the study. The 5-year recurrence-free, overall, and disease-specific survival rates (Kaplan–Meier method) were 71.4%, 94.4%, and 100.0%. Voice function was preserved; the objective parameter VEM (64 ± 33 vs. 83 ± 31; mean ± SD) and subjective vocal measures (G: 1.9 ± 0.7 vs. 1.3 ± 0.7; VHI-9i: 18 ± 8 vs. 9 ± 9) even improved significantly (p < 0.001). The VEM best reflected self-perceived voice impairment. It represents a sensitive measure of voice function for quantification of vocal performance.
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Course of Self-Reported Dysphagia, Voice Impairment and Pain in Head and Neck Cancer Survivors. BIOLOGY 2021; 10:biology10020144. [PMID: 33670412 PMCID: PMC7918686 DOI: 10.3390/biology10020144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/28/2021] [Accepted: 02/09/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Head and neck cancer (HNC)-specific symptoms have a substantial impact on health-related quality of life. The aim of this study was to determine whether self-reported dysphagia, voice problems and pain of HNC patients changed over time and whether specific clinical or sociodemographic variables were associated with these symptoms. METHODS HNC patients (n = 299) in an outpatient setting answered questionnaires (Eating Assessment Tool-10; questions from the EORTC QLQ-C30 and EORTC H&N35) on dysphagia, voice problems and pain, collected with the software "OncoFunction" at three different timepoints (t1-t3) after diagnosis. The mean score changes from t1 to t3 were expressed in terms of effect sizes d. The impact of sociodemographic and clinical factors on the course of the variables was tested with multivariate analyses of variance. RESULTS Dysphagia, voice impairment and pain in HNC survivors significantly improved over a period of approximately 14 months after diagnosis. Tumor site, stage, treatment modality, occupational state and ECOG state were significantly correlated with self-reported functional outcome. The pain level of the HNC patients was rather low. CONCLUSIONS Patients suffer from functional impairments after HNC treatment, but an improvement in self-reported symptoms could be demonstrated within this time period.
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