Injection laryngoplasty has no significant impact on voice outcomes after surgery for glottic cancer: Study
Canada: Following surgery for early glottic cancers, there was no significant impact of intra-operative hyaluronic acid (HA) injection laryngoplasty on subjective or objective voice outcomes, reveals a recent study in the Journal of Otolaryngology-Head & Neck Surgery.
The researchers observed that in both the groups, subjective voice scores improved over time; there were however no improvements in Voice Handicap Index-10 VHI-10 or Maximum Phonation Time (MPT) scores in the injection group, over control, at any time points. Also, they did not observe any significant impact of intra-operative HA injection laryngoplasty on subjective or objective voice outcomes after surgery for early glottic cancers.
Transoral laser microsurgery is used widely for the treatment of T1/T2 glottic cancers. Hyaluronic acid is commonly used in vocal cord augmentation. Ayham Al Afif, Queen Elizabeth II Health Sciences Centre, Halifax, Canada, and colleagues examined the impact of intra-operative injection laryngoplasty on voice outcomes in early glottic cancer.
For this purpose, twenty patients were randomized to the treatment group receiving HA injection to the vocal cord contralateral to the lesion; or the control group receiving no injection. Patients had a VHI-10 questionnaire and an MPT measurement preoperatively and at 3, 12, and 24 months post-operatively. The researchers compared the mean change in VHI-10 and MPT, compared to baseline and between time points. Survival estimates were calculated.
The study led to the following findings:
· Mean VHI-10 scores improved over time amongst all patients.
· There were no changes in mean VHI-10 from pre-operative values to 3, 12, or 24 months postoperatively.
· There were no significant differences when comparing various time points between groups.
· There were no significant changes in MPT amongst the groups, or the time-points compared.
· Two-year overall survival was 91.7%; disease-free survival was 80.9%; no difference in recurrence-free survival was seen between the groups.
"Further studies are required to assess the impact of injection laryngoplasty on voice outcomes after TLM," they conclude.
Reference:
Al Afif, A., Rigby, M.H., MacKay, C. et al. Injection laryngoplasty during transoral laser microsurgery for early glottic cancer: a randomized controlled trial. J of Otolaryngol - Head & Neck Surg 51, 12 (2022). https://doi.org/10.1186/s40463-022-00564-y
