High-speed videolaryngoscopy in early glottic carcinoma patients following transoral CO 2 LASER cordectomy
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LARYNGOLOGY
High‑speed videolaryngoscopy in early glottic carcinoma patients following transoral CO2 LASER cordectomy Sachin Gandhi1 · Subash Bhatta1 · Dushyanth Ganesuni1 · Asheesh Dora Ghanpur1 · Shraddha Jayant Saindani1 Received: 2 September 2020 / Accepted: 10 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To compare high-speed videolaryngoscopy (HSV) findings, like open quotient (OQ), vocal fold vibratory onset delay (VFVOD), amplitude symmetry index (ASI) and phase symmetry index (PSI), after 6 months of cordectomy with that after 1 year, and to compare later with the control group. Methods Retrospective analysis of HSV recordings of 33 patients of early glottic carcinoma after cordectomy was performed after 6 months and 1 year of cordectomy with the help of videokymogram and digital kymogram. The control group of ten individuals was selected from patients who came to hospital with complaints other than larynx. The comparison was done for different types of cordectomy separately. Results The mean of OQ, VFVOD, ASI and PSI was found to be significantly higher after 6-month follow-up than after 1-year follow-up, the later was in turn found to be significantly higher than that of the control group, for type II and III cordectomy. The mean of OQ, VFVOD, ASI and PSI for other types of cordectomy also showed similar results, but the significance was not calculated due to less sample size. Conclusion There was significant improvement in OQ, VFVOD, PSI and ASI following CO2 LASER cordectomy after 1 year of follow-up, making it a good management option for early glottic carcinoma. The ability of the HSV to measure variations in the vocal cord vibration, following cordectomy, was well established by this study. Keywords High-speed videolaryngoscopy · Cordectomy · Videokymography · Digital kymography
Introduction Early glottic carcinoma includes T1 and T2 lesions without lymph nodes metastasis. The prognosis of these early tumor has been found to be better in comparison to the latestage carcinoma [1–5]. Hence, the management paradigm has shifted to more conservative surgery for early glottic carcinoma. In the present scenario, any management undertaken for early glottic carcinoma must succeed to clear the disease as well as be able to ensure the preservation of airway, voice and swallowing function. In this regard, transoral CO2 LASER-assisted cordectomy (mentioned as cordectomy from hereon) is becoming a method of choice for management of early glottic carcinoma [6–10]. There are six types of cordectomies performed for early glottic carcinoma as * Subash Bhatta [email protected] 1
Deenanath Mangeshkar Hospital and Research Centre, Erandwane, Pune 411004, India
per European Laryngology Society (ELS) [7, 11]. The type I cordectomy is subepithelial, type II is subligamental, type III is transmuscular, type IV is total or complete cordectomy and type VI is extended cordectomy encompassing the anterior commissure and the anterior part of both the vocal cords.
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