Voice quality after laser cordectomy and vertical hemilaryngectomy

Introduction: Various surgical techniques have been adopted for management of glottic cancer with the aim of eradicating the disease and preserving the voice character. Aim: The aim of the study was to determine the voice quality for patient after various surgical interventions for treatment of cancer larynx, and to evaluate the effect of postoperative voice therapy. Subjects: 20 patients were subjected to surgical intervention for management of glottic cancer (seven had unilateral laser cordectomy-group A, and five had bilateral laser cordectomy-group B and eight had vertical hemilaryngectomy-group C). Thirteen age matched males were randomly selected for obtaining normal computer voice function parameters as the control group-group D. Methodology: The four groups were subjected to protocol of voice evaluation postoperatively. Patients were re-evaluated two months later and a comparison of voice outcome for patients receiving voice therapy and those who did not was conducted. Conclusion: Most acoustic and aerodynamic parameters are significant different between patients from control. Subharmonics parameters (NSH and DSH) and degree of voice breaks (DVB) in addition to phonatory resistance specifically differentiate the voice of laser cordectomized from that of vertical hemilaryngectomized patient, this may reflect occurrence of vocal fry related to supraglottic phonation. Improvement was recorded by all patients receiving voice therapy. Unilateral laser cordectomy gave better phonatory outcome due to less extension of surgical resection and development of glottic phonation. Bilateral laser cordectomy gave relatively worse prognosis highlighting the advantage of the experience of surgeon in creation of pseudoglottis in improving phonatory outcome in vertical hemilaryngectomy over extensive resection of bilaterally cordectomized patients.