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Objective and self-evaluation voice analysis after transoral laser cordectomy and radiotherapy in T1a-T1b glottic cancer

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Abstract

Voice quality outcome becomes an important factor in the choice of the therapeutic option. The differences between radiotherapy and laser cordectomy have been extensively debated in the literature. We analyzed the vocal outcomes after carbon dioxide (CO2) laser cordectomy and radiotherapy treatment for T1a-b early glottic cancer by means of objective and subjective voice evaluation. A retrospective study was performed on 56 cancer patients, 30 treated with cordectomy and 26 with radiotherapy. All patients underwent laser cordectomy which was performed under general anesthesia using a surgical microscope in laryngeal suspension. The laser we used was an Ultrapulse one, 10.6-μm wavelength, and a power setting of 2 to 4 W in an Ultrapulse mode was selected. Two different sets of data were recorded: (a) voice acoustic analysis (jitter, shimmer, fundamental frequency and noise/harmonic ratio) and (b) voice handicap index (VHI). Data collected were statistically analyzed using SPSS 20.0 for Windows. Jitter, shimmer, and signal-to-noise ratio were significantly altered in both glottic cancer patient groups as compared to the control group. On the contrary, no statistically significant alteration of the fundamental frequency was found in both treatment groups. Interestingly, jitter and shimmer values were significantly more compromised in transoral laser surgery patients as compared with radiotherapy-treated patients. The VHI was also significantly altered in both cancer patient groups as compared to the control group. More importantly, however, the self-evaluation voice analysis was not significantly different between the two treatment groups, contrary to what we observed for two of the four parameters measured in the objective voice analysis. Given the importance of the self-perception of the voice quality, no treatment can be considered superior from the patients’ point of view. Therefore, we suggest that priority should be given to the endoscopic surgery, due to lower costs, lower morbidity, and shorter hospitalization.

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Authors and Affiliations

  1. Otolaryngology Head and Neck Surgery, Department of Medical and Surgical Sciences, “Magna Græcia” University of Catanzaro, Campus Universitario, Località Germaneto, Viale Europa, 88100, Catanzaro, Italy

    Nicola Lombardo & Teodoro Aragona

  2. Radiotherapy Unit, Riuniti Hospital, Reggio Calabria, Italy

    Said Alsayyad

  3. Respiratory Disease, Department of Medical and Surgical Sciences, “Magna Græcia” University of Catanzaro, Catanzaro, Italy

    Girolamo Pelaia

  4. Department of Health Sciences, “Magna Græcia” University of Catanzaro, Catanzaro, Italy

    Rosa Terracciano & Rocco Savino

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  1. Nicola Lombardo
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  2. Teodoro Aragona
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  3. Said Alsayyad
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  4. Girolamo Pelaia
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  5. Rosa Terracciano
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  6. Rocco Savino
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Correspondence to Nicola Lombardo.

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The authors declare that they have no conflict of interest.

Ethical approval

This study received approval from the ethics committee of the “Magna Graecia” University of Catanzaro, “Regione Calabria” (approval number 219).

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Lombardo, N., Aragona, T., Alsayyad, S. et al. Objective and self-evaluation voice analysis after transoral laser cordectomy and radiotherapy in T1a-T1b glottic cancer. Lasers Med Sci 33, 141–147 (2018). https://doi.org/10.1007/s10103-017-2361-0

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  • DOI: https://doi.org/10.1007/s10103-017-2361-0

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