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Abstract
Laryngeal carcinoma account for almost one fourth of the approximately 45,000 head and neck malignancies diagnosed in 2007 in the United States, making laryngeal carcinoma one of the most common sites for head and neck cancer. Of these, approximately one half affect the true vocal folds.
Supraglottic and glottic tumors are the most common subsites, and subglottic carcinomas are uniformly rare. In the United States, glottic carcinomas are the most common (glottic, 59%; supraglottic, 40%; subglottic, 1%).
It is fortunate that even the earliest glottic cancer alters the voice by affecting wave pattern forms over the vocal cord, so even carcinoma in situ may produce significant voice change.
The preoperative evaluation of patients with laryngeal carcinoma begins with a thorough history and physical examination in the office with subsequent endoscopy, surgical biopsy and imaging studies.
The treatment of early glottic carcinoma is a topic of great importance and relevance. Glottic laryngeal squamous carcinoma in its early stages has an excellent prognosis. The disease can be effectively treated by external beam radiotherapy, conservative open laryngeal surgery or endoscopic resection.
Laser microsurgery has become an established time-efficient treatment option for early laryngeal cancer .Laser resection provides more therapeutic options for management of persistent or recurrent disease.
Radiotherapy offers the benefits of no surgery and has good local control, survival rates and good quality of voice.
Open surgical procedures for early glottic cancers can be regarded as organ preservation procedures because their aim is to preserve speech and swallowing without a permanent stoma.
Given that there is equality of survival between the treatments, other factors must also be considered in determining treatment, particularly quality of life and cost. Because of the importance of voice in determining a patient’s quality of life, it is obviously crucial to examine this issue. Voice analysis includes patient scales, perceptual evaluation, and measures.
In this study we tried to compare outcomes measures of voice following various treatment modalities of early glottis carcinoma.
Searches for articles published in English language in PubMed (Medline data base) for management of early glottic carcinoma yielded 28 relevant articles, of which only 5 articles were included according to specific inclusion criteria. Among these included articles 2 articles had radiotherapy as an intervention, 2 articles had surgery as an intervention, and 1articles had laser as an intervention.
Our results showed that the voice after radiotherapy had superior voice quality than laser cordectomy. Post treatment voice quality of laser deteriorates as the extent of laser resection increases. The voice after surgery had the least quality of voice.