Abstract
Objective: Providing good vocal outcomes to vocal fold cancer patients, after open or endoscopic cordectomy, is a hot topic. Several authors compared different phono-surgical techniques focusing their attention on feasibility. The aim of our study was to evaluate objective and subjective vocal outcomes after Montgomery thyroplasty. Method: In 2011, at the I ENT Division of Turin University, 8 patients underwent Montogomery thyroplasty followed by 6 months of speech rehabilitation. Inclusion criteria were: glottic incompetence and 3 years of follow-up after cordectomy. Voice evaluation was performed using videolaryngostroboscopy, Multidimensional Voice Program (MDVP), and VHI-10. Results: Six months after the surgical procedure, the laryngostroboscopy showed an improved glottic closure during phonation even if irregular and incomplete. Preoperative and postoperative MDVP parameters were compared by means of Student t test, observing a statistically significant improvement of all parameters ( P < .05). The most relevant improvements were observed in: average fundamental frequency (192 Hz vs 161.7 Hz), absolute jitter (645 µs vs 57 µs), shimmer (2.1 dB vs 0.82 dB), amplitude perturbation quotient (17.6% vs 6.1%), and medium phonation time (3.5 s vs 5.12 s). VHI-10 mean score improved from 33.4 to 25.7 ( P < .05). Conclusion: Our data suggest that Montgomery thyroplasty, associated with speech rehabilitation, is an efficient and well- tolerated rehabilitative approach in order to improve vocal outcomes of vocal fold cancer patients treated with open or endoscopic laser cordectomies.
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