Voice Rehabilitation After Carbon Dioxide Laser Microsurgery For Early Glottic Carcinoma

Part one Early voice rehabilitation after carbon dioxide laser microsurgery for early glottic carcinomaObjectiveThe purpose of this study is to assess the voice rehabilitation of early glottic carcinoma after carbon dioxide laser surgery, in order to make guidance for clinical work.MethodWe studied twenty patients of early glottic carcinoma initially treated by CO2laser microsurgery, conducting videostroboscopy and acoustic voice analysis before the operation and half, one, two, three months later. Five acoustic parameters were evaluated. It includes fundamental frequency, sound pressure level, maximum phonatory time, Fundamental frequency perturbation, dysphonia severity index. The results underwent statistical analysis.Results1. Videostroboscopic examination revealed:With extended time after surgery, The wound of vocal cord healed gradually and the inflammatory response reduced gradually. There is a worst performance after two weeks surgery. The most significant improvement was obtained one month after surgery, and within the two months further significant improvements were noted. Three months later, there is little improvement.2. The acoustic voice analysis revealed:As compared with control, there is a significant difference in all parameters of pre-operation and post-operation (P<0.01). The F0, SPL, MPT, Jitter, DSI after two weeks surgery were worse than pre-operation (P<0.01). Except of DSI, the other parameters after one month surgery were better than two weeks after surgery (P<0.01); the F0(P<0.05), SPL(P<0.05), MPT(P<0.01), Jitter(P<0.01), DSI(P<0.01) after two months surgery, were better than one month after surgery; only MPT(P<0.05) and DSI(P<0.01) after three months surgery, were better than two months after surgery, the other parameters were not significant(P>0.05). The parameters in three months after surgery and preoperative were not significant(P>0.05).Conclusions1. The voice rehabilitation shown a most significant improvement in two months after surgery; Two to three months after surgery, the rehabilitation of voice slow down.2. Three months after surgery, the voice can basically get back to the preoperative level. Part two Observation of new vocal cord of early glottic carcinoma after carbon dioxide laser microsurgeryObjectiveThe aim of this study is to observe the recovery of new vocal cord and to assess the voice rehabilitation, in order to make guidance for calinical work.MethodTen patients of early glottic carcinoma who took carbon dioxide laser surgery more than six monthes ago were assessed. They are all initially treated and with no recurrence. The videostroboscopy was used and the ten patients was divided into two groups by the recovery of new vocal cord. Six acoustic parameters were evaluated. It includes fundamental frequency, sound pressure level, maximum phonatory time, Fundamental frequency perturbation, amplitude perturbation, dysphonia severity index.Results1. There are six patients formed new vocal cord, four patients did not formed, these are two patients have mucosal wave in the six patients who formed new vocal cord.2. The F0, SPL, MPT, Jitter, Shimmer, DSI in group which formed new vocal cord were not significant with the group which didn’t formed new vocal cord(P>0.05), but there is significant difference in MPT, Jitter, DSI than normal people(P<0.01),and no significant difference in F0, SPL, Simmer(P>0.05). In the group which didn’t formed new vocal cord, SPL(P<0.01), Jitter(P<0.01), Shimmer(P<0.05), MPT(P<0.05), DSI(P<0.01) have significant difference than the normal, it worse than the normal people, only FO is not significant(P>0.05).ConclusionThe parameters F0, SPL, Shimmer of the patients who formed new vocal cord can get back to normal level. But in the patients with no new vocal cord, only FO can get back to normal level.