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Evaluation of voice and quality of life after transoral endoscopic laser resection of early glottic carcinoma

Published online by Cambridge University Press:  12 April 2011

Y Bajaj ,
S Uppal ,
R K Sharma ,
A R H Grace ,
D M Howard ,
A R Nicolaides  and
A P Coatesworth
Y Bajaj*
Affiliation:
Department of Otolaryngology, York Hospital, UK
S Uppal
Affiliation:
Department of Otolaryngology, York Hospital, UK
R K Sharma
Affiliation:
Department of Otolaryngology, York Hospital, UK
A R H Grace
Affiliation:
Department of Otolaryngology, York Hospital, UK
D M Howard
Affiliation:
Department of Otolaryngology, York Hospital, UK
A R Nicolaides
Affiliation:
Department of Otolaryngology, York Hospital, UK
A P Coatesworth
Affiliation:
Department of Otolaryngology, York Hospital, UK
*
Address for correspondence: Mr Yogesh Bajaj, 2 Tall Trees, Leeds LS17 7WA, UK Fax:  + 44 (0)1132663305 E-mail: [email protected]
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Abstract

Objective:

This study aimed to evaluate voice and quality of life after transoral laser resection of early glottic carcinoma.

Methods:

We studied 19 patients undergoing transoral laser resection of tumour stage (T) one or T2 glottic carcinoma. Laryngeal function was evaluated by video-stroboscopy, vocal function by the Voice Symptom Scale, the grade-roughness-breathiness-asthenia-strain scale and objective phoniatric assessment, and quality of life by the University of Washington Quality of Life questionnaire.

Results:

Patients’ glottic carcinoma tumour-node-metastasis (TNM) staging was T1 N0 M0 in 14 patients and T2 N0 M0 in five. Overall voice grade, roughness and breathiness were mild to moderate in 84 per cent; asthenia and voice strain were more uniformly distributed, with 15 per cent of patients having normal voice quality. Eight patients developed a glottic web post-operatively; anterior commissure web was significantly associated with worse voice grade (p = 0.05). Seven patients (47 per cent) had a ‘mucosal wave’ on the operated vocal fold; this was significantly associated with less strain on phonation (p = 0.05). Voice Symptom Scale score was low overall (15 patients (78.9 per cent) scored less than 30). The fundamental frequency and frequency irregularity were normal in nine patients (47.3 per cent); the closed quotient was normal in six (31.5 per cent). The averaged quality of life score was ≥90 in 14 patients (73.7 per cent); 18 (94.7 per cent) felt their health-related quality of life was either the same or better post-operatively; and overall quality of life was positive in all.

Conclusion:

Transoral laser resection of T1 and T2 glottic carcinoma enables adequate tumour tissue excision with preservation of acceptable vocal function. Most patients’ post-operative quality of life is very good. Anterior commissure web formation is associated with poorer vocal function.

Keywords

GlottisCarcinomaLaser TherapyQuality Of LifeVoice
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 7 , July 2011 , pp. 706 - 713
Copyright
Copyright © JLO (1984) Limited 2011

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