Comparison between open partial laryngectomy with tube‑free tracheostomy and total laryngectomy for hypopharyngeal cancer with cartilage invasion

Abstract

The present study aimed to identify a feasible treatment strategy for hypopharyngeal cancer (HPC) with non-extensive invasion of the thyroid and/or cricoid cartilage. Between June 2008 and December 2014, patients with previously untreated HPC invading cartilage who had received either open partial laryngectomy (OPL) with tube-free tracheostomy or total laryngectomy (TL) with permanent tracheostomy and an artificial larynx (pneumatic tube) were retrospectively reviewed. The patients with extensive cartilage invasion and those with inoperable or T4b disease were excluded for OPL. Outcomes and quality of life were compared between the two treatment modalities. A total of 44 patients were included. The survival rates, complications, and Dysphagia Score were compared between the two treatment modalities. The outcome of the Voice Handicap Index (P=0.032), understandability of speech (P<0.001), normalcy of diet (P=0.041), senses (P=0.006), speech (P<0.001) and social contact (P=0.004) were significantly improved in the group receiving OPL compared with the group receiving TL. Therefore, OPL with tube-free tracheostomy may be a feasible option to treat patients with HPC with non-extensive invasion of the thyroid and/or cricoid cartilage.

Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): Influences on the Voice Changes and Swallowing Function Disorders

“…Higher F0 values generally indicate higher pitched voices, while lower F0 values indicate lower pitched voices. Measuring F0 can provide valuable insights into vocal fold vibration and voice quality.VHI questionnaire is a validated self-report measure widely used to assess the impact of voice disorders on patients’ quality of life 8,9 . The VHI consists of 30 items covering 3 domains: functional, physical, and emotional 13,14 .…”

“…The general data included age, sex, body mass index, intraoperative blood loss, tumor size, and complications. Special factors associated with voice changes and swallowing disorders were the movement of vocal cords, completion of the Voice Handicap Index (VHI), 8,9 and swallowing impairment score [10][11][12] (SIS, the questionnaire survey in Table supplement, Supplemental Digital Content 1, http://links.lww.com/SLE/ A408), a voice subjective evaluation system [GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) classification], 13,14 and objective acoustic analysis (completed by the XiON, an analysis software), which included fundamental frequency (F0/20), fundamental frequency perturbation (jitter), amplitude perturbation (shimmer), and maximum phonation time (MPT). F0, also known as fundamental frequency, refers to the lowest frequency component of a complex sound wave produced during phonation.…”

“…Measuring F0 can provide valuable insights into vocal fold vibration and voice quality.VHI questionnaire is a validated self-report measure widely used to assess the impact of voice disorders on patients' quality of life. 8,9 The VHI consists of 30 items covering 3 domains: functional, physical, and emotional. 13,14 The GRBAS system is a perceptual rating scale commonly used by speech-language pathologists and voice professionals to assess various aspects of voice quality.…”

Monitoring and Evaluation of Late Functional Outcome in Post-treatment Follow-Up in Clinical Routine Setting

“…Loss of voice and changed speech are severe problems in many patients who underwent therapy for laryngeal cancer. Superior objective voice outcomes have been reported for patients undergoing a partial laryngectomy when compared to total laryngectomy (24). Conversely, patients self-report higher satisfaction with their voice following laryngectomy than those having a partial laryngectomy (25, 26).…”