Multidimensional voice evaluation in pretreatment glottic carcinoma

It is generally accepted that, in glottic carcinoma, the voice will deteriorate, even in the early stages. This paper reports the degree of hoarseness and multidimensional vocal evaluation of glottic carcinoma patients. Forty-seven male glottic carcinoma patients and a control group of 13 normal subjects were included in this study involving psychoacoustic evaluation by doctors, acoustic analysis, phonogram, maximum phonation time and stroboscopy before treatment. A normal voice or mild hoarseness by psychoacoustic evaluation was found in 35% of cases with T1 and T2 glottic carcinoma. Patients with psychoacoustically inferior vocalization had high scores on acoustic analysis, small phonogram areas, and short maximum phonation time. Stroboscopy revealed attenuation or disappearance of the mucosal wave on the tumor side in all cases, whether the acoustic analysis data were within or beyond the normal limits. We identified two conditions offering superior vocalization in glottic carcinoma patients: (1 ) the lesion should be unilateral, and (2) the lesion should be flat with no protrusion. We should evaluate patients with glottic carcinoma not only with vocal examination but also using stroboscopy before biopsy.