Journal article
Effect of resection depth of early glottic cancer on vocal outcome: An optimized finite element simulation
The Laryngoscope, Vol.125(8), pp.1892-1899
08/2015
DOI: 10.1002/lary.25267
PMCID: PMC4512909
PMID: 26010240
Abstract
Objectives/HypothesisTo test the hypothesis that subligamental cordectomy produces superior acoustic outcome than subepithelial cordectomy for early (T1-2) glottic cancer that requires complete removal of the superficial lamina propria but does not involve the vocal ligament.
Study DesignComputer simulation.
MethodsA computational tool for vocal fold surgical planning and simulation (the National Center for Voice and Speech Phonosurgery Optimizer-Simulator) was used to evaluate the acoustic output of alternative vocal fold morphologies. Four morphologies were simulated: normal, subepithelial cordectomy, subligamental cordectomy, and transligamental cordectomy (partial ligament resection). The primary outcome measure was the range of fundamental frequency (F-0) and sound pressure level (SPL). A more restricted F-0-SPL range was considered less favorable because of reduced acoustic possibilities given the same range of driving subglottic pressure and identical vocal fold posturing.
ResultsSubligamental cordectomy generated solutions covering an F-0-SPL range 82% of normal for a rectangular vocal fold. In contrast, transligamental and subepithelial cordectomies produced significantly smaller F-0-SPL ranges, 57% and 19% of normal, respectively.
ConclusionThis study illustrates the use of the Phonosurgery Optimizer-Simulator to test a specific hypothesis regarding the merits of two surgical alternatives. These simulation results provide theoretical support for vocal ligament excision with maximum muscle preservation when superficial lamina propria resection is necessary but the vocal ligament can be spared on oncological grounds. The resection of more tissue may paradoxically allow the eventual recovery of a better speaking voice, assuming glottal width is restored. Application of this conclusion to surgical practice will require confirmatory clinical data.
Level of EvidenceN/A. Laryngoscope, 125:1892-1899, 2015
Details
- Title: Subtitle
- Effect of resection depth of early glottic cancer on vocal outcome: An optimized finite element simulation
- Creators
- Ted Mau - The University of Texas Southwestern Medical CenterAnil Palaparthi - University of UtahTobias Riede - University of UtahIngo R. Titze - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Laryngoscope, Vol.125(8), pp.1892-1899
- DOI
- 10.1002/lary.25267
- PMID
- 26010240
- PMCID
- PMC4512909
- NLM abbreviation
- Laryngoscope
- ISSN
- 0023-852X
- eISSN
- 1531-4995
- Publisher
- Wiley
- Number of pages
- 8
- Grant note
- R01 DC008612 / National Institute on Deafness and Other Communication Disorders (NIDCD); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Deafness & Other Communication Disorders (NIDCD) R01DC008612 / NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Deafness & Other Communication Disorders (NIDCD)
- Language
- English
- Date published
- 08/2015
- Academic Unit
- School of Music; Communication Sciences and Disorders
- Record Identifier
- 9984719576702771
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