Effectiveness of transoral laser microsurgery for precancerous lesions and early glottic cancer guided by analysis of voice quality

Bahannan, Abdulrahman Ali; Slavícek, A; Černý, Libor; Vokřál, Jan; Valenta, Zdeněk; Lohynská, Radka; Chovanec, Martin; Betka, Jan

doi:10.1002/hed.23368

Cited by 22 publications

(27 citation statements)

References 16 publications

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“…Hence, grading the extent of resection in this study was not reliably feasible by means of distinguishing between type I, type II, or type III resections in both groups, respectively. This is in line with current publications that only distinguish between limited resections (types I‐III) and extended resections (type IV‐V) . Moreover, Greulich et al most recently showed in a meta‐analysis that there is no significant difference in functional voice outcome comparing true European Laryngological Society type I/II resections with type III cordectomies .…”

Section: Discussionsupporting

confidence: 85%

Randomized controlled single‐blinded clinical trial of functional voice outcome after vascular targeting KTP laser microsurgery of early laryngeal cancer

Strieth¹,

Ernst²,

Both³

et al. 2019

Head & Neck

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Background Local control rate (LCR) of early glottic cancer is high after radiation therapy or transoral laser microsurgery (TLM). The aim of this study was to investigate functional voice outcome after TLM using a microvessel‐ablative potassium‐titanyl‐phosphate (KTP) laser in comparison with a gold standard cutting CO2 laser. Methods The primary end point of this prospective, randomized, single‐blinded, clinical phase II study with control group was voice outcome during a follow‐up of 6 months assayed by Voice Handicap Index (VHI‐30)‐questionnaires in patients with unilateral high‐grade dysplasia, carcinoma in situ or early glottic cancer undergoing TLM‐KTP (n = 8) or TLM‐CO2 (n = 12). The secondary end point was LCR. Results Starting from the 9‐week‐follow‐up visit, TLM‐KTP yielded significantly reduced VHI scores compared to TLM‐CO2. No relapse occurred after TLM‐KTP in contrast to one recurrence after TLM‐CO2 within 6 months. Conclusion Multicenter phase II or III studies on voice outcome or local control rate after TLM‐KTP in early glottic cancer are warranted enrolling larger patient cohorts.

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Section: Discussionsupporting

confidence: 85%

Randomized controlled single‐blinded clinical trial of functional voice outcome after vascular targeting KTP laser microsurgery of early laryngeal cancer

Strieth¹,

Ernst²,

Both³

et al. 2019

Head & Neck

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“…However, a clear distinction before invasive diagnostic would be essential for therapy planning. On the one hand, as malignant transformation in low dysplasia degrees is rather rare (6,7), unnecessarily augmented excision and the risk of unfavorable scarring could be prevented when presurgical diagnostics would be sufficiently reliable (8). On the other hand, knowing about the malignant nature of a lesion could accelerate the adequate therapy and lead to better functional outcome either by excision or radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

A Noninvasive Procedure for Early-Stage Discrimination of Malignant and Precancerous Vocal Fold Lesions Based on Laryngeal Dynamics Analysis

et al. 2015

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About two thirds of laryngeal cancers originate at the vocal cords. Early-stage detection of malignant vocal fold alterations, including a discrimination of premalignant lesions, represents a major challenge in laryngology as precancerous vocal fold lesions and small carcinomas are difficult to distinguish by means of regular endoscopy only. We report a procedure to discriminate between malignant and precancerous lesions by measuring the characteristics of vocal fold dynamics by means of a computerized analysis of laryngeal high-speed videos. Ten patients with squamous cell T1a carcinoma, ten with precancerous lesions with hyperkeratosis, and ten subjects without laryngeal disease underwent high-speed laryngoscopy yielding 4,000 images per second. By means of wavelet-based phonovibrographic analysis, a set of three clinically meaningful vibratory measures was extracted from the videos comprising a total number of 15,000 video frames. Statistical analysis (ANOVA with post hoc two-sided t tests, P < 0.05) revealed that vocal fold dynamics is significantly affected in the presence of precancerous lesions and T1a carcinoma. On the basis of the three measures, a discriminating pattern was extracted using a support vector machine-learning algorithm performing an individual classification in respect to the different clinical groups. By applying a leave-one-out cross-validation strategy, we could show that the proposed measures discriminate with a very high performance between precancerous lesions and T1a carcinoma (sensitivity, 100%; specificity, 100%). Although a large-scale study will be necessary to confirm clinical significance, the set of vibratory measures derived in this study may be applicable to improve the accuracy and reliability of noninvasive diagnostics of vocal fold lesions. Cancer Res; 75(1); 31-39. Ó2014 AACR.

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“…The case group included 24 males (80%), and this proportion was similar to that of the control group (n 5 8, 80%). The average number of surgeries that treated the vocal cords was 3.4 (CO 2 : 2.2; KTP: 1.2; range, 1-8) and the average value of the Derkay/Coltrera score at the time of the first surgical intervention was 10.8 (range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. These values were highly correlated with the number of surgeries (r 5 0.72), suggesting that patients with higher preoperative scores tended to require more frequent surgeries.…”

Section: Resultsmentioning

confidence: 99%

Multidimensional vocal assessment after laser treatment for recurrent respiratory papillomatosis

et al. 2016

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Effectiveness of transoral laser microsurgery for precancerous lesions and early glottic cancer guided by analysis of voice quality

Abstract: Effect of transoral laser microsurgery on quality of voice depends on the type of cordectomy and the site of the lesion.

Cited by 22 publications

References 16 publications

Randomized controlled single‐blinded clinical trial of functional voice outcome after vascular targeting KTP laser microsurgery of early laryngeal cancer

Randomized controlled single‐blinded clinical trial of functional voice outcome after vascular targeting KTP laser microsurgery of early laryngeal cancer

A Noninvasive Procedure for Early-Stage Discrimination of Malignant and Precancerous Vocal Fold Lesions Based on Laryngeal Dynamics Analysis

Multidimensional vocal assessment after laser treatment for recurrent respiratory papillomatosis

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