Voice Assessment and Quality of life after endoscopic laser cordectomie
Résumé
Objectives: Endoscopic laser cordectomy is a minimally invasive surgical technique for T1 glottic carcinoma. The purpose of the study was to evaluate prospectively before and 3 months after surgery i) acoustic and perceptual parameters, ii) quality of life through a self evaluation (VHI) test. Methods: This longitudinal study was a preliminary evaluation of 12 male patients, 6 of them with a type I cordectomy, 3 with a type II cordectomy, and 3 with a type V cordectomy. Patients were recorded before and at 1 and 3 months after surgery. Acoustic parameters (F0, Jitter, Shimmer, Maximal and Minimal F0 and Intensity parameters) were recorded with MDVP and Voice Range Profile (Kay Elemetrics) as well as Maximum Phonation Time (MPT). Voices were perceptually evaluated using the GRBAS scale. The Dysphonia Severity Index (DSI) was measured as well as the self evaluation with the Voice Handicap Index (VHI). Results: No statistics could be done because of the limited number of patients in each group. Perceptual and self evaluation data have a favorable evolution between 1 and 3 months for all patients. Acoustic parameters improve for type I and II cordectomy, but not for type V cordectomy because the voice remains whispery at 3 months after surgery. Conclusions: The quality of voice is a very important criterion for the patients. During the first 3 months after laser cordectomy, the perceptual vocal function and the self evaluation improves. But for the acoustic data, 3 months is probably too short to objectively quantify an improvement especially after type V cordectomy.