Voice Quality After Anterior Commissure Cordectomy Versus Marginal Cordectomy for cT1 Glottic Carcinoma: A Case-Series

Objectives: To compare the presurgical to postsurgical voice quality (VQ) outcomes of types I, II, III, and VI transoral laser cordectomies (TLC).

Study design: Prospective uncontrolled study.

Setting: Multicenter study.

Methods: Patients treated with TLC for a cT1 glottic squamous cell carcinoma were recruited from 2 European hospitals. The pre- to 3-, 6-, and 12-month post-TLC VQ was investigated with the voice handicap index (VHI), GRBAS, speech rate, maximal phonation time (MPT), and acoustic parameters. VQ was compared between types of TLC (types I, II, III, VI).

Results: Ninety-six patients completed the evaluations (16 females). The TLC consists of type I (N = 30), II (N = 27), III (N = 19), and VI (N = 20), respectively. The mean ages of groups ranged from 55.3 to 65.5 years. The VQ significantly improved from pre- to 3-, and 12-month post-TLC in types I, II, and III TLC groups. Only grade of dysphonia was significantly improved in type VI TLC after 6- and 12-month post-TLC. Type VI TLC reported higher values of F0, breathiness, and percent jitter than types I to III TLC 6- and 12-month after the surgery. Percent jitter, F0, and the breathiness were the voice outcomes that highlight the differences in VQ between TLC groups.

Conclusion: The pre- to 12-month post-TLC evolution of VQ is better in types I-II TLC compared to types III and VI. Type VI TLC reported the worse VQ at baseline and throughout the follow-up.