Phoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, Treviso, Italy.
ENT Section, Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy.
Am J Otolaryngol. 2024 Jul-Aug;45(4):104272. doi: 10.1016/j.amjoto.2024.104272. Epub 2024 Mar 31.
In early glottic squamous cell carcinoma, similar results have been described in terms of disease control between transoral laser microsurgery (TLM) and radiation therapy (RT). During the past two decades, several studies compared subjective vocal outcomes of exclusive RT with those of TLM, showing a trend towards improving results for TLM over time. However, the objective differences in terms of spectro-acoustic voice parameters between exclusive RT and TLM have been less frequently investigated. The aim of this systematic review with meta-analysis was to evaluate voice quality after TLM and RT treatment for early glottic carcinoma, based on acoustic analysis parameters including jitter, shimmer, noise to harmonic ratio, fundamental frequency and maximum phonation time.
A search of the English published literature was conducted on the Pubmed, Scopus and Cochrane databases following PRISMA guidelines.
A total of 441 titles were retrieved from the search. After full-text screening and application of inclusion/exclusion criteria, 12 articles were included. We found no significant differences between TLM and RT treatment in the considered acoustic analysis parameters, except for Shimmer, with more favorable values reported in the RT group.
Considering the spread of the disease and expecting an improvement in long-term survival over time, well-designed and multicentric studies involving larger populations with a long-term follow up are mandatory to better assess objective voice outcomes in terms of spectro-acoustic voice parameters.
在早期声门型鳞状细胞癌中，经口激光显微手术（TLM）与放射治疗（RT）在疾病控制方面的效果相似。在过去的二十年中，多项研究比较了单纯 RT 与 TLM 的主观嗓音结果，显示 TLM 的疗效随时间推移而改善的趋势。然而，单纯 RT 与 TLM 之间在声谱学嗓音参数方面的客观差异却较少被研究。本系统评价与荟萃分析的目的在于评估基于声门分析参数（包括微扰、抖动、噪声与谐噪比、基频和最长发声时间）的 TLM 和 RT 治疗早期声门型癌后的嗓音质量。
根据 PRISMA 指南，在 Pubmed、Scopus 和 Cochrane 数据库中对英文发表文献进行了检索。
从检索中总共获取了 441 个标题。经过全文筛选和纳入/排除标准的应用，共纳入了 12 篇文章。除了抖动外，我们在考虑的声门分析参数中未发现 TLM 和 RT 治疗之间有显著差异，RT 组报告的抖动值更有利。
考虑到疾病的扩散，并期望随着时间的推移长期生存率提高，需要进行设计良好且多中心的研究，纳入更多的患者，并进行长期随访，以更好地评估基于声谱学嗓音参数的客观嗓音结果。
