Department of Otolaryngology, Medical University of Warsaw, Poland.
Arch Med Sci. 2011 Feb;7(1):143-53. doi: 10.5114/aoms.2011.20621. Epub 2011 Mar 8.
An analysis of long term voice quality outcomes of two different types of surgical intervention for Tis and T1 glottic carcinoma: laryngofissure conventional cordectomy and endoscopic laser CO(2) cordectomy, with or without additional radiation therapy.
Total of 46 patients with Tis and T1 glottic carcinoma served as subjects. All have been treated surgically with laryngofissure conventional cordectomy (32.61%) or endoscopic laser CO(2) cordectomy (67.39%). The surgeries were performed in the Department of Otolaryngology at the Medical University of Warsaw (1990-2004). The presented voice assessments were made at least 3 years following the surgery, in between January 2006 and February 2007.
In patients after the endoscopic laser CO(2) cordectomy the following findings are more often observed: the unrestrained voice production, wider range of Fo in a spoken sentence, longer maximum phonation time, better intensity of phonation for normal and loud speaking, lower degree of hoarseness based on the Yanagihara's classification, and the lower VHI. No significant influence of the performed additional radiotherapy on voice parameters was found.
Patients after endoscopic laser CO(2) cordectomy, compared to laryngofissure conventional cordectomy, present better voice quality. The amount of the excised vocal fold tissue, which in our study was slightly larger in case of the conventional cordectomy, could account for the results mentioned above. This may also be explained by the necessity of the anterior thyrotomy, which is required for conventional cordectomy via external approach, and often results in anterior synechia and level difference between the neocord and the contralateral vocal fold.
两种不同手术干预Tis 和 T1 声门型喉癌的长期嗓音质量分析：喉裂开常规声带切除术和内镜激光 CO2 声带切除术，是否联合放射治疗。
共 46 例Tis 和 T1 声门型喉癌患者作为研究对象。所有患者均接受手术治疗，采用喉裂开常规声带切除术（32.61%）或内镜激光 CO2 声带切除术（67.39%）。手术均在华沙医科大学耳鼻喉科进行（1990-2004 年）。于 2006 年 1 月至 2007 年 2 月之间，至少在手术后 3 年进行了所呈现的嗓音评估。
在接受内镜激光 CO2 声带切除术的患者中，更常观察到以下发现：不受限制的发声、在口语句子中 Fo 范围更广、最长发声时间更长、正常和大声说话时发声强度更好、根据 Yanagihara 分类的嘶哑程度较低，以及 VHI 较低。未发现所行附加放疗对嗓音参数有显著影响。
与喉裂开常规声带切除术相比，接受内镜激光 CO2 声带切除术的患者嗓音质量更好。我们的研究中，常规声带切除术切除的声带组织量略多，这可能导致了上述结果。这也可以解释为需要进行外侧入路的常规声带切除术的前甲状软骨切开术，这通常会导致前粘连和新声带与对侧声带之间的水平差异。
