Assessment of Vocal Quality Following Treatment of Advanced Pharyngo-laryngeal Carcinoma With a Protocol of Organ Preservation

Abstract

Introduction and objectivesAdvanced laryngeal and pharyngeal cancer, as well as methods to treat them, have a direct impact on voice function, speech communication and deglutition. Such alterations in function can influence employability and general quality of life. Patients and methodsTo characterise the vocal status of the patients treated with an organ-preservation protocol, we report the voice outcomes of 17 patients who were alive and disease free at the time of the survey, with a minimum follow-up of 6 months, after a combination of radiotherapy and chemotherapy to treat advanced cancer. Objective voice assessment by means of spectrographic analysis, the GRBAS perceptual analysis system and the Voice Handicap Index was the methodology followed, which we suggest could be used in future large-scale investigations. ResultsNormal or slightly dysphonic voices were observed in five patients (29.4%) and moderate/severe in 12 (70.6%). Spectrographically, the 17 samples were classified as normal in four cases (23.4%), Grade I in three cases (17.6%), Grade II in three (17.6%), Grade III in four (23.5%) and Grade IV in two (11.7%). The Voice Handicap Index questionnaire, which was completed by the patients themselves, gave normal results in all the patients except for four (23.5%). ConclusionsThe voice acoustic analysis of this series shows that the damage related to the organ-preservation protocol displays a relatively wide range of voice function outcomes. To characterise the vocal status of these patients reliably, we propose using homogeneous instruments (spectrography, GRBAS scale, maximum phonation time and Voice Handicap Index) in future meta-analyses.