Volume 34, Issue 10 pp. 1422-1427
Original Article

Modified type III cordectomy to improve voice outcomes after transoral laser microsurgery for early glottic canser

Pen-Yuan Chu MD

Corresponding Author

Pen-Yuan Chu MD

Department of Otolaryngology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan

Department of Otolaryngology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, TaiwanSearch for more papers by this author
Yen-Bin Hsu MD

Yen-Bin Hsu MD

Department of Otolaryngology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan

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Tsung-Lun Lee MD

Tsung-Lun Lee MD

Department of Otolaryngology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan

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Sherry Fu MSP

Sherry Fu MSP

Department of Otolaryngology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan

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Li-Mei Wang MS

Li-Mei Wang MS

Department of Otolaryngology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan

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Ya-Chung Kao MS

Ya-Chung Kao MS

Department of Otolaryngology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan

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First published: 03 November 2011
Citations: 8

Abstract

Background

We proposed a modified type III cordectomy for the treatment of early glottic cancer that removed the upper part of the vocalis muscle to improve glottic closure and voice outcomes.

Methods

Twenty-two patients with early glottic cancer underwent type III cordectomy, including 9 classical (proposed by European Laryngological Society) and 13 modified resections. Multidimensional voice evaluations were performed.

Results

Voice parameters including GRBAS (overall grade [G], roughness of the voice [R], breathiness [B], asthenicity [A], and strain [S]), jitter, shimmer, noise-to-harmonic ratio, maximum phonation time, voice handicap index-functional, physical, and total scores were better in modified resection. Eleven patients (85%) had complete glottic closure in modified resection and 3 (33%) in classical resection (p = .026). Only 2 patients had tumor recurrence, 1 (8%) in the modified resection and 1 (11%) in the classical resection group (p = 1.000).

Conclusions

Modified type III cordectomy proved to be an oncologically safe method. The voice outcomes were better than those in patients who underwent classical type III cordectomy. © 2011 Wiley Periodicals, Inc. Head Neck, 2011

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