'How does that sound?': objective and subjective voice outcomes following CO₂ laser resection for early glottic cancer.

OBJECTIVE

To investigate the effect of transoral laser microsurgery for early glottic cancer on subjective and objective vocal outcome measures.

DESIGN

Prospective cohort study.

SETTING

Tertiary care cancer centre.

PARTICIPANTS

All patients scheduled for transoral laser microsurgery for untreated early primary glottic cancer over a 22-month period and offered voice assessment (31 patients; 19 tumour stage one, 12 tumour stage two).

MAIN OUTCOME MEASURES

Fundamental frequency, maximum phonation time, calculated jitter, shimmer and subjective voice rating, analysed by tumour stage.

RESULTS

Tumour stage T1 patients had significantly different fundamental frequencies and maximum phonation times at three months post-operatively, compared with pre-operative values; these differences resolved by 12 months. At 12 months, tumour stage T2 patients had significantly shorter maximum phonation times, and all patients reported significantly worse subjective voice ratings, compared with pre-operative values.

CONCLUSION

We found no change in fundamental frequency, jitter and shimmer, one year post-operatively. Maximum phonation time deteriorated but stage one patients appeared to compensate, whereas stage two patients did not. Resection size may be a factor. All patients reported significantly worse subjective voice ratings at one year. Aerodynamic and subjective voice measures appear most sensitive to change in this patient group.