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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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References

1Gotay, CC, Moore, TD. Assessing quality of life in head and neck cancer. Quality of Life Research 1992;1:5–17CrossRefGoogle ScholarPubMed
2Rogers, SN, Lowe, D, Brown, JS, Vaughan, ED. A comparison between the University of Washington Head and Neck disease-specific measure and the Medical Short Form 36, EORTC QOQ-C33 and EORTC Head and Neck 35. Oral Oncology 1998;34:361–72Google Scholar
3Wuyts, FL, Bodt, MSD, Molenberghs, G, Remacle, M. The dysphonia severity index: an objective measure of vocal quality based on a multiparameter approach. J Speech Lang Heari Res 2000;43:796–810Google Scholar
4Deary, IJ, Wilson, JA, Carding, PN, MacKenzie, K. VoiSS – a patient derived Voice Symptom Scale. J Psychosom Research 2003;54:483–9Google Scholar
5Mendenhall, WM, Werning, JW, Hinerman, RW, Amdur, RJ, Villaret, DB. Management of T1-T2 glottic carcinomas. Cancer 2004;100:1786–92Google Scholar
6Smith, JC, Johnson, JT, Cognetti, DM, Landsittel, DP, Gooding, WE, Cano, ER et al. Quality of life, functional outcome and costs of early glottic cancer. Laryngoscope 2003;113:68–76Google Scholar
7Stewart, MG, Chen, AY, Stach, CB. Outcome analysis of voice and quality of life in patients with laryngeal cancer. Arch Otol Head Neck Surgery 1998;124:143–8Google Scholar
8McGuirt, WF, Blalock, D, Koufman, JA, Feehs, RS, Hilliard, AJ, Greven, K et al. Comparative voice results after laser resection or irradiation of T1 vocal cord carcinoma. Arch Otol Head Neck Surgery 1994;120:951–5Google Scholar
9Wilson, JA, Webb, A, Carding, PN, Steen, IN, MacKenzie, K, Dearey, IJ. The Voice Symptom Scale (VoiSS) and the Vocal Handicap Index (VHI): a comparison of structure and content. Clin Otol 2004;29:169–74Google Scholar
10Weymuller, EA Jr, Alsarraf, R, Yueh, B, Deleyiannis, FWB, Coltrera, MD. Analysis of the performance characteristics of the University of Washington Quality of Life instrument and its modification (UW-QOL-R). Arch Otol Head Neck Surg 2001;127:489–93Google Scholar
11Fairbanks, G. Voice and Articulation Drill Book, 2nd edn.New York: Harper, 1960Google Scholar
12Steiner, W. Results of curative laser microsurgery of laryngeal carcinomas. Am J Otol 1993;14:116–21Google Scholar
13Sittel, C, Friedrich, G, Zorowka, P, Eckel, HE. Surgical voice rehabilitation after laser surgery for glottic carcinoma. Ann Otol Rhinol Laryngol 2002;111:493–9Google Scholar
14Colden, D, Jarboe, J, Zeitels, SM, Bunting, G. Stroboscopic assessment of vocal fold keratosis and glottic cancer. Ann Otol Rhinol Laryngol 2001;110:293–9Google Scholar
15Hsiung, M, Lu, P, Kang, B, Wan, H. Measurement and validation of the voice handicap index in voice-disordered patients in Taiwan. J Laryngol Otol 2003;117:478–81Google Scholar
16Murry, T, Rosen, CA. Outcome measurements and quality of life in voice disorders. Otolaryngol Clin North Am 2000;33:905–16Google Scholar
17Jacobson, BH, Johnson, A, Grywalski, C, Silbergleit, A, Jacobson, G, Benninger, MS et al. The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol 1997;6:66–70Google Scholar
18Brondbo, K, Benninger, MS. Laser resection of T1a glottic carcinomas: results and postoperative voice quality. Acta Otolaryngol 2004;124:976–9Google Scholar
19Stoeckli, SJ, Guidicelli, M, Schneider, A, Huber, A, Schmid, S. Quality of life after treatment for early laryngeal carcinoma. Eur Arch Otorhinolaryngol 2001;258:96–9Google Scholar