Quantitative analysis of voice quality in early glottic laryngeal carcinomas treated with radiotherapy

Abstract

The quality of voice after radiotherapy is generally considered to be better than that after surgery for early glottic (T1a and T1b) carcinomas. Studies concerning voice quality after radiotherapy are scarce, and results have been contradictory concerning actual normalization of voice following therapy. This study was designed to compare several voice parameters of patients successfully treated 1-12 years previously with radiotherapy (5750-7000 cGy) for early glottic carcinoma. Parameters involved an age- and sex-matched control group. Results showed that voice quality following radiotherapy was less than normal for maximum vocal intensity, dynamic vocal intensity range, jitter, and mean fundamental frequency. These findings showed that voice following radiotherapy could not be considered normal.

Multidimensional Assessment of Voice Characteristics After Radiotherapy for Early Glottic Cancer

“…Vocal function following radiotherapy, evaluated by means of videolaryngostroboscopy, appeared to be normal in 60% to 86% of the patients, whereas perceptual analysis revealed that 55% of these patients had normal voice quality. These findings are within in the wide range of results in the literature, varying from voice improvement to a normal or near‐normal level for at least 70% of the patients 10–17 to abnormal postradiation voices for the majority of cases 2–9 . In our study, voice quality following radiotherapy was influenced mainly by age of the speaker and stripping rather than performing biopsy of the vocal cords for initial diagnosis, while stroboscopic analyses of vocal function revealed that next to increasing age and stripping the vocal cord, continued smoking after treatment decreased vocal function following radiotherapy.…”

“…In the literature on voice characteristics following radiotherapy, a variety of voice parameters is used. It seems that different results to some extent can be attributed to this variety: some studies report abnormal postradiation voices, 2–9 whereas others report voice improvement to a normal or near‐normal level for at least 70% of the patients 10–17 . In earlier research, we described detailed investigations concerning voice quality following radiotherapy for early glottic cancer by means of perceptual and acoustical analyses 18 .…”

How often is total laryngectomy necessary for the treatment of T1 failures after radiotherapy or cordectomy?

“…Some studies, however, question this statement [7]. Dagli et al [5] also demonstrated that voice could not be considered normal after radiotherapy in early-stage glottic tumors. Remacle et al [26] and Zeitels [36] have published excellent phonetic results after surgical therapy.…”

Avaliação da voz em pacientes submetidos à cordectomia com laser de CO2

“…Hocevar-Boltezar et al (2000) 41 and Dagli et al (1997) 42 also found increased jitter and shimmer values and a higher fundamental frequency compared to controls in irradiated patients assessed objectively. Such results may be explained by post-radiation vocal fold fibrosis and rigidity in both sides.…”