Voice Outcome and Quality of Life after Trasoral Laser Microsurgery for Glottic Cancer

Abstract

Objectives: Transoral laser microsurgery is considered one of the best techniques for the treatment of early stage glottic cancer. But voice outcome and quality of life (QOL) after laser cordectomy has not been fully evaluated. The aim of this study is to evaluate the voice outcome and QOL after transoral laser cordectomy in glottic cancer. Methods: We studied 43 glottic cancer patients who underwent transoral laser cordectomy from January 2002 to December 2008, retrospectively. We evaluated objective and subjective voice outcome using acoustic analysis, aerodynamic study, and voice handicap index (VHI). We also assessed QOL using EORTC QLQ-C30/H&N35 questionnaire at preoperative and postoperative 6 to 12 months. We analyzed the correlation between voice outcome and QOL according to the types of laser cordectomy. Results: Postoperative harmonic to noise ratio, maximum phonation time, and VHI score was significantly improved from preoperative scores in patients who underwent type I-II cordectomy ( P = .010, P < .001, and P = .013, respectively). Functional VHI score after Types I-II cordectomy group (2.25 ± 6.08) was significantly lower than that of Types III-VI cordectomy group (7.26 ± 6.96; P = .043). Postoperative QOL score was not different between Types I-II (73.71 ± 12.96) and Types III-VI (82.37 ± 27.32) cordectomy groups ( P = .437). However, postoperative QOL score had a positive correlation with postoperative VHI score (Spearman ρ = 0.494, P = .017). Conclusions: Objective and subjective voice outcome after laser cordectomy showed favorable results, especially in patients who underwent Type I or II laser cordectomy.