Wedman J, Heimdal J-H, Elstad I, Olofsson Jan
Haukeland University Hospital, Department of Otolaryngology, Head and Neck Surgery, Bergen, Norway.
Eur Arch Otorhinolaryngol. 2002 Nov;259(10):547-50. doi: 10.1007/s00405-002-0478-6. Epub 2002 Jul 5.
Early squamous cell carcinomas of the glottis can be treated effectively by means of surgery or external beam radiotherapy. The curability rate is about the same for both treatment modalities, but differing results have been reported regarding functional results. We selected 24 patients from a larger group of patients who had been treated for T1a glottic laryngeal cancer without the involvement of the anterior commissure. Fifteen patients were treated endoscopically and nine by radiotherapy. During a routine control videolaryngostroboscopy at an outpatient clinic, an objective and a subjective voice analysis were performed. The objective and subjective voice analyses showed no differences between the two treatment modalities. Videolaryngostroboscopy showed a significantly more pronounced glottic wave at the side that was originally affected by the tumour in the radiotherapy group. This difference disappeared when we looked at both vocal cords. Significant differences between the two treatment modalities were not found in any of the other parameters. Thus, this study shows no difference in the voice quality of patients treated by irradiation or by endoscopy. Therefore, the post-treatment voice quality is not a reason to favour radiotherapy for small T1a glottic squamous cell cancers without involvement of the anterior commissure.
早期声门鳞状细胞癌可通过手术或外照射放疗有效治疗。两种治疗方式的治愈率大致相同，但关于功能结果的报道却有所不同。我们从一大组接受T1a期声门型喉癌治疗且前联合未受累的患者中选取了24例患者。15例患者接受了内镜治疗，9例接受了放疗。在门诊进行常规的动态喉镜检查时，进行了客观和主观的嗓音分析。客观和主观嗓音分析显示两种治疗方式之间没有差异。动态喉镜检查显示，放疗组中最初受肿瘤影响一侧的声门波明显更明显。当观察双侧声带时，这种差异消失了。在其他任何参数中均未发现两种治疗方式之间存在显著差异。因此，本研究表明接受放疗或内镜治疗的患者嗓音质量没有差异。所以，对于无前联合受累的小T1a期声门鳞状细胞癌，治疗后的嗓音质量并不是倾向于放疗的理由。
