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As treatments for T1a midcord glottic carcinoma, endoscopic laser surgery and radiotherapy provide similar voice outcomes, according to a report.

As treatments for T1a midcord glottic carcinoma, endoscopic laser surgery and radiotherapy provide similar voice outcomes, according to a report in the Archives of Otolaryngology - Head and Neck Surgery for September.

Both treatments also achieve similar oncologic control, although endoscopic laser surgery may be the favored approach due to lower cost, shorter treatment time, and the possibility of successive operations, Dr. Elisabeth V. Sjogren and co-researchers state.

In their study, Dr. Sjogren, from Leiden University Medical Center in the Netherlands, and colleagues used a multidimensional protocol to assess voice quality in 18 patients who had been treated with laser surgery and 16 treated with radiotherapy.

The protocol, based on European Laryngological Society recommendations, included acoustic, aerodynamic, perceptual, and stroboscopic analyses. The Voice Handicap Index was used for patient self-assessment.

In the perceptual analysis, eight of 15 (53 per cent) radiation-treated patients and 11 of 18 (61 per cent) surgery patients had mild to moderate voice dysfunction. The corresponding proportions on the Voice Handicap Index were seven of 16 (44 per cent) and ten of 18 (56 per cent). No significant differences were noted between the groups in the severity of voice dysfunction on any of the variables tested.

There were, however, some differences in voice character between the groups. While patients treated with surgery mainly had a breathy-sounding voice, those given radiotherapy had voices that were equal parts breathy and rough. On acoustic analysis, more jitter was also noted in the voices of radiotherapy patients.

The current findings, the researchers conclude, support prior research suggesting that endoscopic surgery and radiotherapy yield similar voice outcomes in patients treated for T1a midcord glottic carcinoma.

Arch Otolaryngol Head Neck Surg 2008;134:965-972