Voice Quality After Treatment of Early Glottic Carcinoma

Voice Outcomes After Transoral Laser Microsurgery for Early Glottic Cancer—Considering Signal Type and Smoothed Cepstral Peak Prominence

“…A number of studies have reported improved voice outcomes over the first 12 months after TLM, presumably owing to vocal fold healing and the potential benefits of voice rehabilitation. 9,12,20,56 To our knowledge, the number of laser episodes to achieve an oncologically satisfactory resection and the impact of TLM-related complications have not been previously reported in relation to postoperative voice outcomes. Considering these in relation to newly applied voice assessment methods may be clinically relevant.…”

“…9,18 However, one study 12 found high perturbation values, and another study 19 found higher (worse) values than controls. For more extensive resections, low perturbation values were reported 20 ; however, a number of other studies showed high measures. 12,17,19,[21][22][23][24] Owing to the heterogeneity of noise measures used in previous studies, comparisons were difficult to make.…”

“…Compared with other studies investigating voice outcomes after TLM, 9,12,[16][17][18][19][20][21][22][23][24]40 perturbation and noise measures were a small part of our assessment battery, analyzing only three participants owing to concerns regarding reliability in most signals. Without signal typing and pitch-tracking analysis, perturbation values for all 14 participants would have been reported with the risk of reporting unreliable results.…”

“…16,18,19 Comparisons were also difficult owing to the various software programs used. Although most studies 12,17,19,[21][22][23][24] used the Multidimensional Voice Profile (Kay Elemetrics, Pine Brook, NJ), 25 other studies 16,18,20 used Doctor Speech (Tiger DRS Inc) 26 and one study 9 used Praat (Paul Boersma, www.praat.org). 27 It has been suggested that there are poor comparisons between perturbation measures generated from various acoustic analysis programs.…”

“…It has been reported that calculating perturbation and noise measures for aperiodic signal types 3 and 4 yields unreliable results, and therefore it has been recommended that perturbation and noise measures be calculated from type 1 and some type 2 signals only. 33,37 The studies reporting perturbation outcomes after TLM 12,[17][18][19][20][21][22]40 did not conduct signal typing to determine which signals could be reliably analyzed, suggesting the need to reconsider the reliability of such results.…”