Objective and Subjective Comparison of the Quality of Voice Between Two Available Surgical Approaches in T1b Glottic Cancer

Background: This study aimed to assess differences in the quality of voice results of open frontolateral partial laryngectomy with imbrications laryngoplasty and transoral laser microsurgery in T1b glottic carcinoma. Methods: In this randomized clinical trial, 20 patients with T1b glottic cancer who were candidates for surgery were randomly (using the blocked randomization method) assigned to schedule for frontolateral partial laryngectomy with imbrications laryngoplasty (n = 7) or transoral laser microsurgery (Va extended cordectomy) (n = 10). The objective and subjective voice results were assessed using voice analysis parameters (jitter, shimmer, harmonics to noise ratio, and maximum phonation time). The Voice Handicap Index (VHI) questionnaire was used with 30 statements consisting of three domains including functional, physical, and emotional aspects of voice disorders. Results: No statistically significant differences were noted between laser surgery and open procedure in objective voice analysis parameters. The voice was significantly disturbed after both procedures but subjective analysis of the voice by the VHI questionnaire showed more statistically significant patients’ satisfaction in the laser group. The mean VHI was 77.29 ± 8.51 after vertical hemilaryngectomy and 65.60 ± 13.08 after laser cordectomy that was significantly lower in the latter procedure (P = 0.042). Conclusions: Despite the imbrications of laryngoplasty in open surgery, no statistically significant differences were noted in objective voice parameters. However, more patients’ satisfaction was noted regarding voice in laser surgery. When considering modality, we need to assess factors such as individual anatomic factors, complete tumor exposure (depth of tumor in anterior commissure), professional needs, quality of life, and cost-effectiveness. With regard to the semi-invasive nature of laser use and more patients’ satisfaction based on the VHI questionnaire, this method is prioritized in comparison with the surgical procedure as vertical hemilaryngectomy.