Source:http://linkedlifedata.com/resource/pubmed/id/12498379
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:dateCreated |
2002-12-24
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| pubmed:abstractText |
Phonosurgical management of early glottic cancer has evolved considerably, but objective vocal outcome data are sparse. A prospective clinical trial was done on 32 patients with unilateral cancer (T1a in 28 and T2a in 4) who underwent ultranarrow-margin resection; 15 had resection superficial to the vocal ligament, and 17 deep to it. The subepithelial infusion technique facilitated selection of these patients for the appropriate procedure. All are cancer-free without radiotherapy or open surgery. Involvement of the anterior commissure (22/32) or the vocal process (15/32) of the arytenoid cartilage did not influence local control. Nine of 17 patients had resection of paraglottic musculature, and all underwent medialization reconstruction by lipoinjection and/or Gore-Tex laryngoplasty. Eight of the 17 had resections deep to the vocal ligament, but without vocalis muscle, and 1 of the 8 underwent medialization. Posttreatment vocal function measures were obtained for all patients. A clear majority of the patients displayed normal values for average fundamental frequency (72%) during connected speech, and normal noise-to-harmonics ratio (75%) and average glottal airflow (91%) measures during sustained vowels. Smaller majorities of patients displayed normal values for average sound pressure level (SPL; 59%) during connected speech and for maximum ranges for fundamental frequency (56%) and SPL (59%). Fewer than half of the patients displayed normal values for sustained vowel measures of jitter (45%), shimmer (22%), and maximum phonation time (34%). Almost all patients had elevated subglottal pressures and reduced values for the ratio of SPL to subglottal pressure (vocal efficiency). There were significant improvements in a majority of patients for most vocal function measures after medialization reconstruction. Normal or near-normal conversation-level voices were achieved in most cases, regardless of the disease depth, by utilization of a spectrum of resection and reconstruction options. These favorable results are based on establishing aerodynamic glottal competency and preserving the layered microstructure of noncancerous glottal tissue.
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:status |
MEDLINE
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| pubmed:month |
Dec
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| pubmed:issn |
0096-8056
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| pubmed:author | |
| pubmed:issnType |
Print
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| pubmed:volume |
190
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
3-20
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| pubmed:dateRevised |
2008-2-21
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| pubmed:meshHeading |
pubmed-meshheading:12498379-Disease-Free Survival,
pubmed-meshheading:12498379-Dissection,
pubmed-meshheading:12498379-Female,
pubmed-meshheading:12498379-Follow-Up Studies,
pubmed-meshheading:12498379-Glottis,
pubmed-meshheading:12498379-Humans,
pubmed-meshheading:12498379-Laryngeal Neoplasms,
pubmed-meshheading:12498379-Laryngectomy,
pubmed-meshheading:12498379-Laryngoscopy,
pubmed-meshheading:12498379-Laser Therapy,
pubmed-meshheading:12498379-Male,
pubmed-meshheading:12498379-Microsurgery,
pubmed-meshheading:12498379-Neoplasm Invasiveness,
pubmed-meshheading:12498379-Phonation,
pubmed-meshheading:12498379-Sound,
pubmed-meshheading:12498379-Surgical Flaps,
pubmed-meshheading:12498379-Treatment Outcome,
pubmed-meshheading:12498379-Voice Quality
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| pubmed:year |
2002
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| pubmed:articleTitle |
Voice and treatment outcome from phonosurgical management of early glottic cancer.
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| pubmed:affiliation |
Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
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| pubmed:publicationType |
Journal Article
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