Long-term vocal functional results after glottectomy: a multi-dimensional analysis

Horizontal glottectomy (HG) is an efficient surgical procedure for the treatment of selected laryngeal carcinoma. The aim of this study was to verify the long-term voice results in a group of HG subjects. The study involved 16 subjects who had undergone HG at least 1 year before. Each subject underwent laryngoscopy and his/her voice was perceptually rated using the GRBAS (grade, roughness, breathiness, asthenicity, strain) scale; the other objective examinations included maximum phonation time (MPT), spectrography, and perturbation analysis. Finally, all of the subjects assessed their own voice using the voice handicap index (VHI). The endoscopic examinations showed good arytenoid mobility and antero-posterior valving of the arytenoid-epiglottal-ventricular band complex, whereas vibration of the neoglottis was more severely impaired. The mean GRBAS values were, respectively, 2.7, 1.9, 1.9, 0.9 and 0.7; the mean MPT was 8.2 s. The Yanagihara score of the voice spectrograms was 4 in all cases; perturbation analysis revealed the following mean values: fundamental frequency = 147; Jitter% = 6.5; Shimmer% = 13.9; and noise-to-harmonic ratio = 0.76. The mean VHI value was 35.8. Objective and subjective data showed a dysphonic voice after HG, whereas the self-assessment results revealed a low degree of perceived disability, suggesting that oral communication was well preserved.