Subjective and objective voice outcomes after transoral laser microsurgery for early glottic XXXX .

@entity5 @entity1 @entity189 @entity1141
OBJECTIVES/HYPOTHESIS: Transoral laser microsurgery (TLM) continues to gain popularity as a treatment modality for early glottic @entity5 . Oncologic outcomes have been well-defined, but there are little data to date describing functional outcomes accounting for stage of resection. STUDY DESIGN: Retrospective review. METHODS: We retrospectively reviewed @entity1 -rated voice handicap and observer-rated vocal quality of @entity1 who underwent TLM for early @entity189 . @entity1 were grouped by European Laryngological Society (ELS) resection type, and the data were combined for ELS type I-III and compared with advanced resections (ELS IV-VI). The Voice Handicap Index (VHI) was used for @entity1 -rated voice outcomes, and voice recordings were graded by two senior speech-language pathologists. Voice recordings and VHI scores were taken preoperatively and at least 1 month postoperatively. RESULTS: No major complications were encountered. Six of 49 @entity1 underwent repeat resection for suspicious findings with pathology, demonstrating moderate @entity1141 in two cases, @entity189 in situ in two cases, and inflamed mucosa only in two cases. There was no significant difference in preoperative VHI scores or objective voice grades among @entity1 who underwent limited (ELS I-III) and those who required more advanced (ELS IV-VI) resection. There was a significant improvement in VHI scores in @entity1 after ELS type I to III resection, from 38.77 to 22.86 (P   =   .006). There was no significant difference between mean preoperative and postoperative perceptual evaluation scores in @entity1 who underwent ELS type I, II, or III resections (62.25 and 64.32 respectively, P   =   .621). CONCLUSIONS: @entity1 who undergo limited ELS resections can be assured of having a similar to improved voice after healing. @entity1 who undergo extended resections have poorer vocal outcomes. LEVEL OF EVIDENCE: 4 Laryngoscope, 126:405-407, 2016.
