Voice outcomes following laser cordectomy for early glottic cancer: a physical model investigation.

OBJECTIVES/HYPOTHESIS 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. STUDY DESIGN Physical phonatory modeling. METHODS The influence of vocal fold surgical defects and corresponding scar was experimentally investigated using a self-oscillating physical model of the vocal folds and compared with the baseline model without defects or scar. RESULTS Results showed that increasing anterior-posterior extent of resection increased phonation threshold pressure and flow rate and reduced excitation of high-order harmonics, resulting in a more breathy and rough voice production. However, it was found that voice production was improved with the placement of scar, which increased both excitation of high-order harmonics and the harmonic-to-noise ratio. CONCLUSIONS Although large anterior-posterior surgical resections resulted in progressive impact on vocal measures, a limited excision of the vocal fold cover surprisingly demonstrated minimal voice changes. Further investigations are required to define the acceptable extent of surgical resection that may result in optimal voice outcomes.