嗓音质量分析指导下经口激光显微手术治疗癌前病变及早期声门癌的疗效

Effectiveness of transoral laser microsurgery for precancerous lesions and early glottic cancer guided by analysis of voice quality.

作者信息

Bahannan Abdulrahman Ali, Slavíček Aleš, Černý Libor, Vokřal Jan, Valenta Zdenek, Lohynska Radka, Chovanec Martin, Betka Jan

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, First Faculty of Medicine, Charles University, Prague, Czech Republic.

出版信息

Head Neck. 2014 Jun;36(6):763-7. doi: 10.1002/hed.23368. Epub 2013 Jul 30.

DOI:10.1002/hed.23368

PMID:23616355

Abstract

BACKGROUND

The purpose of this study was to show our comparison of the quality of voice obtained after superficial transoral endoscopic cordectomies (types I, II, and III) according to the European Laryngological Society classification versus the more extended cordectomy (types IV and V) among patients with glottic precancerous lesions or early glottic cancer.

METHODS

Sixty-two patients underwent vocal assessment after cordectomy (types I-V) for dysplasia, Tis, T1a, T1b, and T2 lesions.

RESULTS

Cordectomy (types I-III) had good vocal outcomes. Cordectomy (types IV-V) showed less favorable outcomes, p < .005 in common parameters of voice range profile and symmetry in stroboscopy after cordectomy (types IV-V), with significant voice handicap index. Recurrences were found in 4 patients with T1b and T2 cancer. Two cases were managed by a higher type of cordectomy, and the other 2 by total laryngectomy.

CONCLUSION

Effect of transoral laser microsurgery on quality of voice depends on the type of cordectomy and the site of the lesion.

摘要

背景

本研究的目的是展示我们对声门癌前病变或早期声门癌患者，根据欧洲喉科学会分类进行的浅表经口内镜声带切除术（I、II和III型）与更广泛的声带切除术（IV和V型）后获得的声音质量的比较。

方法

62例患者因发育异常、Tis、T1a、T1b和T2病变接受了声带切除术后（I-V型）的嗓音评估。

结果

声带切除术（I-III型）有良好的嗓音结果。声带切除术（IV-V型）显示出不太理想的结果，在声带切除术（IV-V型）后的嗓音范围剖面图和频闪喉镜检查对称性的常见参数中，p < 0.005，嗓音障碍指数显著。4例T1b和T2期癌症患者出现复发。2例通过更高类型的声带切除术处理，另外2例通过全喉切除术处理。