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Jan Betka - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of transoral laser microsurgery for precancerous lesions and early glottic cancer guided by analysis of voice quality
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2014Co-Authors: Abdulrahman Bahannan, Ales Slavicek, Libor Cerný, Jan Vokřal, Z Valenta, Radka Lohynska, Martin Chovanec, Jan BetkaAbstract:Background The purpose of this study was to show our comparison of the quality of voice obtained after superficial transoral endoscopic cordectomies (types I, II, and III) according to the European Laryngological Society classification versus the more extended Cordectomy (types IV and V) among patients with glottic precancerous lesions or early glottic cancer. Methods Sixty-two patients underwent vocal assessment after Cordectomy (types I–V) for dysplasia, Tis, T1a, T1b, and T2 lesions. Results Cordectomy (types I–III) had good vocal outcomes. Cordectomy (types IV–V) showed less favorable outcomes, p < .005 in common parameters of voice range profile and symmetry in stroboscopy after Cordectomy (types IV–V), with significant voice handicap index. Recurrences were found in 4 patients with T1b and T2 cancer. Two cases were managed by a higher type of Cordectomy, and the other 2 by total laryngectomy. Conclusion Effect of transoral laser microsurgery on quality of voice depends on the type of Cordectomy and the site of the lesion. © 2013 Wiley Periodicals, Inc. Head Neck 36: 763–767, 2014
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Effectiveness of transoral laser microsurgery for precancerous lesions and early glottic cancer guided by analysis of voice quality.
Head & neck, 2013Co-Authors: Abdulrahman Bahannan, Ales Slavicek, Jan Vokřal, Z Valenta, Radka Lohynska, Martin Chovanec, Libor Černý, Jan BetkaAbstract:Background The purpose of this study was to show our comparison of the quality of voice obtained after superficial transoral endoscopic cordectomies (types I, II, and III) according to the European Laryngological Society classification versus the more extended Cordectomy (types IV and V) among patients with glottic precancerous lesions or early glottic cancer. Methods Sixty-two patients underwent vocal assessment after Cordectomy (types I–V) for dysplasia, Tis, T1a, T1b, and T2 lesions. Results Cordectomy (types I–III) had good vocal outcomes. Cordectomy (types IV–V) showed less favorable outcomes, p
Abie H. Mendelsohn - One of the best experts on this subject based on the ideXlab platform.
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Longitudinal Voice Outcomes Following Advanced CO2 Laser Cordectomy for Glottic Cancer
Journal of voice : official journal of the Voice Foundation, 2015Co-Authors: Abie H. Mendelsohn, Georges Lawson, Nayla Matar, Vincent Bachy, Marc RemacleAbstract:Summary Objective CO 2 laser Cordectomy for glottic carcinoma offers excellent oncologic control on a per stage basis as compared with primary radiotherapy. We aim to further investigate the fluctuations of postoperative vocal outcomes following extended laser Cordectomy for glottic cancer. Design Single center retrospective cohort study. Methods Eleven patients with glottic squamous cell carcinoma (SCC) who received CO 2 laser Cordectomy European Laryngological Society type III-IV with complete datasets at preoperative, immediate postoperative (within 4 months), and delayed (greater than 6 months) time points were included. Results All patients (n = 11) received Cordectomy as their primary treatment. Tumor stage was divided evenly between T1 and T2. One patient was referred for post-Cordectomy thyroplasty. Mean Voice Handicap Index (VHI) scores increased in the immediate postoperative period (43.3–46.2) but did not reach significance ( P > 0.05). Delayed postoperative VHI (23.3) demonstrated substantial improvement from both pre- and immediate postoperative levels ( P = 0.047). Objective voice rating significantly declined initially ( P = 0.03; Grade, P = 0.01; Breathiness) and recovered to similar preoperative levels. Maximum phonation time (MPT) showed substantial decreases at the initial postoperative period ( P = 0.007). Although significant improvement was made at the delayed postoperative point ( P = 0.009), MPT remained below the preoperative level ( P = 0.028). No significant changes were seen in phonatory subglottic pressures. Conclusions Patients undergoing extended CO 2 laser Cordectomy for glottic cancers can experience initial decline in voice quality; however, vocal function routinely returns to preoperative levels following the initial healing period. A small percentage of extended Cordectomy patients may require further vocal interventions.
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co2 laser Cordectomy for glottic squamous cell carcinoma involving the anterior commissure voice and oncologic outcomes
European Archives of Oto-rhino-laryngology, 2015Co-Authors: Abie H. Mendelsohn, Devora Kiagiadaki, Georges Lawson, Marc RemacleAbstract:Transoral CO2 laser Cordectomy for squamous cell carcinoma (SCC) of the glottis has resulted in excellent voice and oncologic outcomes as compared with non-surgical therapy. However, published experience with primary CO2 laser Cordectomy specifically for glottic SCC involving the anterior commissure (AC) is limited. A review of single academic institution experience with CO2 laser Cordectomy for glottic SCC involving the AC. Patients undergoing European Laryngological Society (ELS) classification Cordectomy type Va or type VI between 2005 and 2013 were included. Post-surgical voice analysis was performed by speech language pathologists (SLP) from the reporting institution. Thirty patients were identified for inclusion. Mean post-surgical follow-up time was 47.6 months (range 11–59). Initial local recurrence was identified in 5/30 (16.7 %) patients. 2/5 recurrences were successfully salvaged by repeat CO2 laser resections, 2/5 ultimately required salvage total laryngectomy, and 1/5 patient developed a second primary preventing further curative treatment. Overall laryngeal preservation rate was 28/30 (93.3 %). Overall survival of the study cohort was 96.7 %. Mean postoperative voice handicap index-120 score was 36.9 (SD = 21.4). Perceptual analysis performed on the GRBAS scale resulted in mean scores: G = 2.1 (SD = 0.9), R = 1.3 (SD = 1.1), B = 1.6 (SD = 1.2). Though cancers involving the AC represent an aggressive subgroup of glottic SCC, CO2 laser Cordectomy results in encouraging oncologic and voice outcomes without the need for further therapy in the majority of cases. Clinical trials are encouraged to further define optimal treatment recommendations for glottic SCC involving the AC.
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CO_2 laser Cordectomy for glottic squamous cell carcinoma involving the anterior commissure: voice and oncologic outcomes
European Archives of Oto-Rhino-Laryngology, 2015Co-Authors: Abie H. Mendelsohn, Devora Kiagiadaki, Georges Lawson, Marc RemacleAbstract:Transoral CO_2 laser Cordectomy for squamous cell carcinoma (SCC) of the glottis has resulted in excellent voice and oncologic outcomes as compared with non-surgical therapy. However, published experience with primary CO_2 laser Cordectomy specifically for glottic SCC involving the anterior commissure (AC) is limited. A review of single academic institution experience with CO_2 laser Cordectomy for glottic SCC involving the AC. Patients undergoing European Laryngological Society (ELS) classification Cordectomy type Va or type VI between 2005 and 2013 were included. Post-surgical voice analysis was performed by speech language pathologists (SLP) from the reporting institution. Thirty patients were identified for inclusion. Mean post-surgical follow-up time was 47.6 months (range 11–59). Initial local recurrence was identified in 5/30 (16.7 %) patients. 2/5 recurrences were successfully salvaged by repeat CO_2 laser resections, 2/5 ultimately required salvage total laryngectomy, and 1/5 patient developed a second primary preventing further curative treatment. Overall laryngeal preservation rate was 28/30 (93.3 %). Overall survival of the study cohort was 96.7 %. Mean postoperative voice handicap index-120 score was 36.9 (SD = 21.4). Perceptual analysis performed on the GRBAS scale resulted in mean scores: G = 2.1 (SD = 0.9), R = 1.3 (SD = 1.1), B = 1.6 (SD = 1.2). Though cancers involving the AC represent an aggressive subgroup of glottic SCC, CO_2 laser Cordectomy results in encouraging oncologic and voice outcomes without the need for further therapy in the majority of cases. Clinical trials are encouraged to further define optimal treatment recommendations for glottic SCC involving the AC.
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Voice outcomes following laser Cordectomy for early glottic cancer: A physical model investigation
The Laryngoscope, 2014Co-Authors: Abie H. Mendelsohn, Yue Xuan, Zhaoyan ZhangAbstract:Objective The voice effects following laser Cordectomy for early glottic cancer are poorly described. We investigated the voice outcomes of subligamentous Cordectomy of progressive anterior-posterior extent of excision.
Daniel Brasnu - One of the best experts on this subject based on the ideXlab platform.
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Identifying outcome predictors of transoral laser Cordectomy for early glottic cancer.
Head & Neck, 2015Co-Authors: Caroline Hoffmann, Stéphane Hans, Babak Sadoughi, Daniel BrasnuAbstract:Background The purpose of this study was to determine the predictors of outcomes in patients with early glottic cancer treated by transoral laser Cordectomy. Methods This was an inception cohort study of 201 patients with early glottic cancer who were treated by transoral laser Cordectomy. Five-year Kaplan–Meier analyses were realized. Results Patients with anterior commissure involvement (n = 75) had a significantly lower disease-free survival (DFS) rate (54.6% vs 79.8%; p = .0004), ultimate local control with laser alone rate (71.0% vs 95.7%; p
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Voice Assessment and Quality of life after endoscopic laser cordectomie
2008Co-Authors: Lise Crevier-buchman, Stéphane Hans, Isabelle Colomb, Jacqueline Vaissière, Daniel BrasnuAbstract: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.
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Evolution of voice assessment and quality of life after endoscopic laser Cordectomy
Revue de laryngologie - otologie - rhinologie, 2007Co-Authors: Lise Crevier-buchman, Stéphane Hans, Isabelle Colomb, Jacqueline Vaissière, Daniel BrasnuAbstract:Objectives Endoscopic laser Cordectomy is a minimally invasive surgical technique for Tis, T1 and selected T2 glottic carcinoma. The purpose of the study was to evaluate prospectively pre-operatively and 3 months after surgery i) acoustic and perceptual parameters, ii) quality of life through a self evaluation (VHI) test. Methods A prospective longitudinal evaluation of 13 male patients, shared-out onto 3 surgical procedures (Cordectomy type I, grouped type II and III, and type V). Patients were recorded before and at 1 and 3 months after surgery. The parameters recorded were; acoustic parameters (F0, Jitter, Shimmer), Maximum Phonation Time (MPT), perceptual evaluation using the GRBAS scale and the self evaluation scale 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 showed a favorable progression between 1 and 3 months for patients in group Type I, II and III Cordectomy. Evolution of acoustic parameters is more difficult to analyze. The voice of the Cordectomy type V group remains whispery at 3 months after surgery. Conclusion 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.
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Early-stage glottic cancer: oncological results and margins in laser Cordectomy.
Archives of otolaryngology--head & neck surgery, 2006Co-Authors: Elizabeth Sigston, Stéphane Hans, Erwan De Mones, Emmanuel Babin, Dana M. Hartl, Philippe Clément, Daniel BrasnuAbstract:Objectives To assess local control of early-stage glottic cancer by laser Cordectomy in comparison with previously published external partial laryngectomy series and to determine the relevance of histological margins in glottic cancers excised with laser Cordectomy. Design Retrospective review of laser Cordectomy for carcinoma in situ (Tis) and stage T1 glottic cancer from January 1991 to January 2004. Setting University hospital. Patients Fifty-two patients with Tis or T1 glottic cancer. Intervention Endoscopic laser Cordectomy, classified using the system proposed by the European Laryngeal Society Working Committee. Main Outcome Measures Local control after initial surgery and after salvage compared with a published historical control group, according to the type of Cordectomy performed and the histological margins of the removed specimen. Results Sixteen patients with Tis, 30 with T1a tumors, and 6 with T1b tumors were followed up for an average of 38 months. Type I Cordectomy was the most common procedure used to treat Tis, and type II and type III were the most common for treating T1a and T1b tumors. Of 6 recurrences, 4 were treated with laser Cordectomy and 2 were treated with external partial laryngectomy. The rate of laryngeal preservation was 100%. There were 3 recurrences despite histologically clear margins. Three (17%) of 18 patients with suspicious margins developed recurrences. The rate of local control with single intervention (46 [89%] of 52) was lower than with partial external laryngectomy. However, 46 (89%) of 52 patients ultimately had less tissue removed by laser than would have been removed by external partial laryngectomy. Conclusions Laser Cordectomy provides excellent local control and laryngeal preservation. Close follow-up of patients with positive or suspicious margins is an alternative to further routine treatment.
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Endoscopic Cordectomy. A proposal for a classification by the Working Committee, European Laryngological Society.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated wi, 2000Co-Authors: Marc Remacle, H. E. Eckel, Daniel Brasnu, D. Chevalier, Gerhard Friedrich, Jan Olofsson, Heinrich Rudert, W Thumfart, M. De VincentiisAbstract:The European Laryngological Society is proposing a classification of different laryngeal endoscopic cordectomies in order to ensure better definitions of post-operative results. We chose to keep the word "Cordectomy" even for partial resections because it is the term most often used in the surgical literature. The classification comprises eight types of cordectomies: a subepithelial Cordectomy (type I), which is resection of the epithelium; a subligamental Cordectomy (type II), which is a resection of the epithelium, Reinke's space and vocal ligament; transmuscular Cordectomy (type III), which proceeds through the vocalis muscle; total Cordectomy (type IV); extended Cordectomy, which encompasses the contralateral vocal fold and the anterior commissure (type Va); extended Cordectomy, which includes the arytenoid (type Vb); extended Cordectomy, which encompasses the subglottis (type Vc); and extended Cordectomy, which includes the ventricle (type Vd). Indications for performing those cordectomies may vary from surgeon to surgeon. The operations are classified according to the surgical approach used and the degree of resection in order to facilitate use of the classification in daily practice. Each surgical procedure ensures that a specimen is available for histopathological examination.
Michel Van Agthoven - One of the best experts on this subject based on the ideXlab platform.
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Cordectomy by co2 laser or radiotherapy for small t1a glottic carcinomas costs local control survival quality of life and voice quality
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2007Co-Authors: Kim M Goor, Jeanne A G E Peeters, H F Mahieu, Johannes A Langendijk, Rene C Leemans, Irma Verdonckde M Leeuw, Michel Van AgthovenAbstract:Background The clinical results of radiotherapy and endoscopic Cordectomy for T1a glottic carcinoma are reported to be similar, but costs of both treatments may differ. Therefore, we retrospectively evaluated the costs, voice quality, quality of life, and clinical results of both treatments. Methods Costs and effects from the first visit up to 2 years of follow-up were calculated, based on chart data of 35 and 54 patients who were treated with curative intent for T1a glottic carcinoma from 1995 to 1999 with radiotherapy and endoscopic Cordectomy, respectively. Voice quality and quality of life were evaluated by means of patient questionnaires. Results Total costs (in Euros) of radiotherapy and CO(2)-laser Cordectomy were 8322 euro and 4434 euro, respectively, including the costs of treating possible recurrences. The effects of both treatments were equal, including voice quality and quality of life. Conclusions We conclude that endoscopic Cordectomy is an efficient alternative for radiotherapy for these patients.
Zhaoyan Zhang - One of the best experts on this subject based on the ideXlab platform.
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Voice outcomes following laser Cordectomy for early glottic cancer: A physical model investigation
The Laryngoscope, 2014Co-Authors: Abie H. Mendelsohn, Yue Xuan, Zhaoyan ZhangAbstract:Objective The voice effects following laser Cordectomy for early glottic cancer are poorly described. We investigated the voice outcomes of subligamentous Cordectomy of progressive anterior-posterior extent of excision.