Sobrevida del cáncer glótico en estadio inicial en 4 centros hospitalarios de Uruguay / Survival of glottic cancer in the initial stage in 4 hospital centers in Uruguay / Sobrevivência de câncer glótico em estágio inicial em 4 hospitais uruguaios

Introducción: El cáncer de laringe es el tumor maligno de mayor prevalencia en la Otorrinolaringología. La topografía glótica es la más frecuente en Uruguay y suele detectarse en estadios tempranos dada la manifestación precoz y sostenida de disfonía. El objetivo de este estudio es describir la sobrevida libre de enfermedad (SLE) y la sobrevida global (SG) de los pacientes con cáncer de laringe glótico en estadio T1N0M0 en 4 instituciones de Montevideo. Metodología: Se analizó de forma retrospectiva la SG y SLE de 55 pacientes diagnosticados con cáncer de glotis T1 entre los años 2009 y 2019. Para el cálculo de la sobrevida se utilizó el método de Kaplan-Meier. Se estudió además el efecto de variables pronósticas de interés sobre la SG mediante análisis univariado y multivariado. Resultados: En la muestra analizada la SG de los pacientes con cáncer glótico T1N0M0 fue como media de 7.706 años (IC 95% 6.63 - 8.78). A los 5 años, la SG fue de 77.5% (± 7%) y de 62% (± 9.8%) a los 10 años. La SLE para todos los pacientes correspondió al 74.6% (± 7.5%) y 63.1% (± 9.8%), a 5 y 10 años respectivamente. No se alcanzaron las medianas de SG ni de SLE para los grupos. Conclusiones: Los valores de SG y SLE medios obtenidos en nuestro medio son comparables a los valores reportados en la bibliografía internacional. No se alcanzó la mediana de SG ni de SLE, por lo que se puede afirmar que ésta enfermedad tiene, cuando se realiza el tratamiento adecuado, un buen pronóstico vital a los 10 años. Se requiere un seguimiento más largo para determinar las medianas de SG y SLE de los grupos en estudio.

Introduction: Laryngeal cancer is the most prevalent malignant tumor in Otorhinolaryngology. Glottic topography is the most frequent in Uruguay and is usually detected in early stages given the early and sustained manifestation of dysphonia. The objective of this study is to analyze disease-free survival (DFS) and overall survival (OS) of patients with stage T1N0M0 glottic laryngeal cancer at 4 institutions in Montevideo. Methodology: The mean OS and DFS of 55 patients diagnosed with T1 glottic cancer between 2009 and 2019 were retrospectively analyzed. Kaplan-Meier method was used to calculate survival. The prognostic effect of certain variables of interest on OS was also studied using univariate and multivariate analysis. Results: In this study, mean odds survival (OS) for T1N0M0 glottic cancer was 7.706 years (CI 95% 6.63 - 8.78). At 5 years, OS was 77.5% (± 7%) and at 10 years was 62% (± 9.8%). Disease free survival (DFS) was 74.6% ± (7.5%) at 5 years and 63.1% (± 9.8%), at 10 years. Median OS and DFS for the groups were not reached. Conclusions: OS and DFS in our medium is comparable to that reported in the international literature. The median OS and DFS were not reached, so it can be stated that this disease has, when appropriate treatment is performed, a good vital prognosis at 10 years. Longer follow-up is required to determine the median OS and DFS of the study groups.

Introdução: O câncer de laringe é o tumor maligno mais prevalente na Otorrinolaringologia. A topografia glótica é a mais frequente no Uruguai e geralmente é detectada em estágios iniciais devido à manifestação precoce e sustentada da disfonia. O objetivo deste estudo é analisar a sobrevida livre de doença (DFS) e a sobrevida global (OS) de pacientes com câncer de laringe glótico estágio T1N0M0 em 4 instituições em Montevidéu. Metodologia: Foram analisados retrospectivamente o OS e DFS de 55 pacientes diagnosticados com câncer glótico T1 entre 2009 e 2019. O método de Kaplan-Meier foi usado para calcular a sobrevida. Resultados: Na amostra, a sobrevida global (OS) do câncer glótico T1N0M0 foi em média de 7.706 anos (IC 95% 6,63 - 8,78). Aos 5 anos, a OS foi de 77,5% (± 7%) e 62% (± 9,8%) aos 10 anos. A DFS para todos os pacientes correspondeu a 74,6% (± 7,5%) e 63,1% (± 9,8%), aos 5 e 10 anos, respectivamente. As medianas de OS e DFS para os grupos não foram alcançadas. Conclusões: OS e DFS em nosso ambiente é comparável ao relatado na literatura internacional. As medianas de SG e SLD não foram alcançadas, pelo que se pode afirmar que esta doença apresenta, quando realizado tratamento adequado, um bom prognóstico vital aos 10 anos. É necessário um acompanhamento mais longo para determinar a mediana da SG e da SLD dos grupos de estudo.

Is it Always Laryngopharyngeal Reflux? How Voice Disorders Can Manifest as LPR

Introduction: Laryngopharyngeal reflux (LPR) manifests with a constellation of common throat symptoms and inconclusive signs on laryngoscopic exam. It is a diagnosis, often made clinically, that can lead to prescriptions of proton pump inhibitors that are unnecessary and potentially harmful. Glottic insufficiency (GI) and the accompanying hyperfunctional laryngeal behaviors can also present with similar, common throat complaints that may or may not include a qualitative change to the voice. Methods: This is a reflection article. It is written to summarize, explain, and support with evidence the opinion of the author on the topic of how symptoms of voice disorders can easily be mistaken for symptoms of LPR. The offered reflection is based on his experience, research and the available literature. Reflection: This article intends to explore the similarities between GI and LPR, how to ultimately differentiate them and how to approach treatment with a broader differential diagnosis. Conclusion: LPR and GI can present with identical, vague throat, and voice symptoms. Empiric medication trials, behavioral interventions and objective laryngovideostroboscopy, impedance-based reflux, and esophageal motility testing may all be needed, sometimes in a trial and error fashion, to correctly diagnose and treat a patient's symptoms.

Introducción: El reflujo laríngeo-faríngeo (LPR, por sus siglas en inglés) se manifiesta con una serie de síntomas comunes en la garganta y signos no concluyentes en el examen larinoscópico. Es un diagnóstico que a menudo se realiza clínicamente y que puede llevar a la prescripción de inhibidores de la bomba de protones que son innecesarios y potencialmente perjudiciales. La insuficiencia glótica (IG) y los comportamientos laríngeos hiperfuncionales que la acompañan también pueden presentar síntomas de garganta comunes similares, que pueden o no incluir un cambio cualitativo en la voz. Métodos: Este es un artículo de reflexión. Está escrito para resumir, explicar y respaldar con evidencia la opinión del autor sobre cómo los síntomas de los trastornos de la voz pueden confundirse fácilmente con los síntomas del LPR. La reflexión ofrecida se basa en su experiencia, investigación y la literatura disponible. Reflexión: Este artículo tiene la intención de explorar las similitudes entre la IG y el LPR, cómo diferenciarlos finalmente y cómo abordar el tratamiento con un diagnóstico diferencial más amplio. Conclusión: El LPR y la IG pueden presentar síntomas idénticos y vagos en la garganta y la voz. Puede ser necesario realizar ensayos de medicación empírica, intervenciones conductuales y pruebas objetivas de laringovideostroboscopia, reflujo basado en impedancia y motilidad esofágica, a veces de manera experimental, para diagnosticar y tratar correctamente los síntomas de un paciente.

Transcutaneous injection of triamcinolone acetonide for persistent glottic granulation after laser microsurgery

Abstract Objective The aim of study was to demonstrate that transcutaneous intralesional injection of Triamcinolone Acetonide (TA) under fibrolaryngoscopy could be an option for persistent granulation after Transoral Laser Microsurgery (TLM) in glottic cancer patients. Methods We recruited 32 patients, who had conservative treatment but failed. 20 patients accepted TA injection monthly until the granulation disappeared or did not shrink further. 12 patients chose to closely monitor. Results For the 20 patients, 17 (85.0%) patients' granulations completely disappeared. 3 (15.0%) patients' granulations had reduced 80%. For the 12 patients, 3 (25.0%) patients' granulations disappeared but 9 (75%) patients' granulations did not have an obvious change. Recurrence was not observed. Conclusion Our experience showed that transcutaneous intralesional TA injection for persistent granulation after TLM through cricothyroid membrane is an efficient, security, harmless and low recurrence method. Especially suitable for huge granulation which blocks the glottis and recur after a second operation.

Analysis of prognostic factors for Tis-2N0M0 early glottic cancer with different treatment methods / Análise de fatores prognósticos para o câncer glótico inicial Tis-2N0M0 com diferentes métodos de tratamento

Abstract Introduction In many regions, laryngeal carcinoma is a common upper respiratory tract cancer, most commonly involving the glottic region. The treatment of early glottic cancer includes radiotherapy, open surgery and laryngeal laser microsurgery. However, the preferred treatment for early glottic cancer is still controversial. Objectives To study the factors affecting the 5-year survival rate of Tis-2N0M0 early glottis cancer and to demonstrate the oncological safety of different treatments. Methods 144 patients with early glottic cancer were analyzed retrospectively. All patients were clinically node negative. 53 patients underwent open surgery, transoral CO2 laser microsurgery in 46 cases and radiotherapy in 45 cases. The patients were followed up for 26 − 84 months, with an average follow-up period of 62.9 months. Results The 5-year overall survival was 82.6%. The 5 year survival rates of open surgery, laser microsurgery and radiotherapy were 83.0%, 82.6% and 82.2%, respectively. There was no significant difference in 5-year survival rate among the three treatments (p= 0.987). In multivariate analysis, age, T-stage, pathological grading, and anterior commissure involvement were important prognostic factors for early glottic cancer. Conclusion There was no significant difference in 5 year survival rate among patients treated by either radiotherapy, laser microsurgery or open surgery for early glottic cancer. We urge more attention to the age, T-stage, pathological grade, and anterior commissure involvement of the patients.

Resumo Introdução Em muitas regiões, o carcinoma de laringe é um câncer comum do trato respiratório superior e geralmente envolve a região glótica. O tratamento do câncer glótico inicial inclui radioterapia, cirurgia aberta e microcirurgia a laser de laringe. Entretanto, a forma preferencial de tratamento do câncer glótico inicial ainda é controverso. Objetivos Estudar os fatores que afetam a taxa de sobrevida em 5 anos do câncer glótico inicial Tis-2N0M0 e demonstrar a segurança oncológica de diferentes tratamentos. Método Um total de 144 pacientes com câncer glótico inicial foram analisados retrospectivamente. Todos os pacientes eram clinicamente negativos para linfonodos. Cinquenta e três pacientes foram submetidos à cirurgia aberta, 46 à microcirurgia transoral a laser de CO2, e radioterapia em 45 casos. Os pacientes foram acompanhados por 26 a 84 meses, com um período médio de seguimento de 62,9 meses. Resultados A sobrevida global em 5 anos foi de 82,6%. As taxas de sobrevida em cinco anos da cirurgia aberta, microcirurgia a laser e radioterapia foram de 83,0%, 82,6% e 82,2%, respectivamente. Não houve diferença significante na taxa de sobrevida em cinco anos entre os três tratamentos (p = 0,987). Na análise multivariada, idade, estágio T, classificação histopatológica e envolvimento da comissura anterior foram fatores prognósticos importantes para o câncer glótico inicial. Conclusão Não houve diferença significante na taxa de sobrevida em 5 anos entre radioterapia, microcirurgia a laser e cirurgia aberta para câncer glótico inicial. Deve-se estar atento à idade, estágio T, histopatológico e envolvimento da comissura anterior dos pacientes.

Management of Early Glottic Cancer Treated by CO2 Laser According to Surgical-Margin Status: A Systematic Review of the Literature

Abstract Introduction Transoral laser microsurgery (TLM) is the treatment of choice for Tis-T2 squamous cell glottic carcinomas due to its advantages compared with open surgery and radiotherapy. However, the CO2 laser beam causes changes and damage on the specimens, making the histological assessment of resection margins, the gold standard for confirming radical tumor resection, sometimes difficult. Objective To assess the different ways to manage patients depending on the status of the histopathological margin according to recent studies to detect the most commonly shared therapeutic strategy. Data Synthesis We analyzed the literature available on the PubMed and Web of Science databases, including only articles published since 2005, using specific keywords to retrieve articles whose titles and abstracts were read and analyzed independently by two authors to detect relevant studies. Therefore, we focused on disease-free survival, overall survival, local control, laryngeal preservation, and disease-specific survival. Thus, 17 studies were included in the present review; they were grouped according to the status of the histological margin, and we analyzed the different management policies described in them. This analysis showed that there is not a shared strategy, though in most studies the authors performed a second-look surgery in the cases of positive margins and a close follow-up in cases of negative ones. The main disagreement is regarding the management of close or non-valuable resection margins, since some some authors performed a second-look surgery, and others, a close follow-up. Conclusions Definitely, the most shared policy is the second-look surgery in case of positive surgical margins, and a close follow-up in case of close or non-valuable resection margins. Key Points To date, TLM is the treatment of choice for Tis-T2 squamous cell glottic carcinomas. The CO2 laser beam could impair the histological assessment of the resection margins, which is the gold standard to confirm radical tumor resection. Second-look TLM is the most performed strategy in case of positive surgical margins. Close follow-up is the most shared policy in case of close or non-valuable resection margins. In cases of negative resection margins, follow-up represents the best approach.

The role of CSE1L expression in cervical lymph node metastasis of larynx tumors / O papel da expressão de CSE1L na metástase em linfonodos cervicais de tumores laríngeos

Abstract Introduction: According to international reports, 30-40% of all head and neck cancers are larynx cancers, comprising 1-2.5% of all cancer types. Cervical nodal involvement has been reported to be 40% and 65% in T3 and T4 cases, respectively. Five-year survival in patients with cervical lymph node metastasis has been demonstrated to be 50% lower compared to patients with no metastasis. Chromosome segregation like 1 protein; is a DNA fragment isolated by Brinkmann et al. in 1995 that corresponds to yeast chromosome segregation protein. Studies on the effect of chromosome segregation like 1 protein expression in head and neck tumors are rare and it has been shown that nuclear chromosome segregation like 1 protein is over-expressed in these studies where gastrointestinal and breast tumors over-expressed cytoplasmic chromosome segregation like 1 protein. Objective: Chromosome segregation like 1 protein may regulate the proliferation and metastasis of T3-T4 glottic larynx cancer. The aim of this study is to show the relationship between chromosome segregation like 1 protein expression and cervical lymph node metastasis of T3-T4 glottic larynx cancer. Methods: A total of 57 male patients who were operated for T3-T4 glottic cancer in a tertiary referral hospital was included in this study. There were 28 patients with cervical lymph node metastasis and 29 patients without lymph node metastasis. Immunohistochemistry was carried out on formalin-fixed, paraffin-embedded archival glottic larynx tumour tissue. According to the percentage of immunoreactive cells, chromosome segregation like 1 protein status was analyzed. Results: Among the patients, who had no cervical lymph node metastasis, 15 patients showed weak nuclear staining, 12 patients showed moderate nuclear staining and only 2 patients showed high nuclear staining for chromosome segregation like 1 protein. Among the patients who had cervical lymph node metastasis, 18 patients showed high nuclear staining, 9 patients showed moderate staining and only one patient showed weak staining for chromosome segregation like 1 protein. None of the metastatic patients showed cytoplasmic staining and only one patient in the non-metastatic group showed cytoplasmic staining for chromosome segregation like 1 protein. There was a positive correlation between nuclear chromosome segregation like 1 protein expression and cervical lymph node metastasis (r = 0,668) and it was statistically significant (p < 0,001). Conclusion: Chromosome segregation like 1 protein expression is correlated with lymph node metastasis in T3-T4 glottic cancers. This may change the approach to cervical node treatment in patients with glottic cancers in future.

Resumo Introdução: De acordo com relatos internacionais, 30% a 40% de todos os casos de câncer de cabeça e pescoço são na laringe, compreendem 1% a 2,5% de todos os tipos de câncer. O envolvimento linfonodal cervical foi relatado em 40% e 65% nos casos T3 e T4, respectivamente. A sobrevida em cinco anos em pacientes com metástase linfonodal cervical demonstrou ser 50% menor em comparação com os pacientes sem metástase. A proteína chromosome seg-regation like 1 é um fragmento de DNA isolado por Brinkmann et al. em 1995 que corresponde à proteína de segregação cromossômica de levedura. Estudos sobre o efeito da expressão da proteína chromosome segregation like 1 em tumores de cabeça e pescoço são raros e os poucos estudos demonstram que a proteína chromosome segregation like 1 nuclear é superexpressa no núcleo, enquanto tumores gastrointestinais e de mama superexpressam a proteína chromosome segregation like 1 citoplasmática. Objetivo: A proteína chromosome segregation like 1 pode regular a proliferação e metástase do câncer glótico de laringe T3-T4. O objetivo deste estudo é mostrar a relação entre a expressão da proteína chromosome segregation like 1 em metástase de linfonodo cervical no câncer glótico de laringe T3-T4. Método: Foram incluídos neste estudo 57 pacientes do sexo masculino submetidos a cirurgias por câncer glótico T3-T4 em um hospital terciário. Havia 28 pacientes com metástase de linfonodos cervicais e 29 pacientes sem metástase linfonodal. A análise imunohistoquímica foi realizada em tecido de tumor glótico de laringe embebido em parafina e fixado em formol. De acordo com a porcentagem de células imunorreativas, analisou-se a expressão da proteína chromosome segregation like 1. Resultados: Entre os pacientes, que não tinham metástase linfonodal cervical, 15 apresentaram coloração nuclear fraca, 12 apresentaram coloração nuclear moderada e apenas 2 apresentaram coloração nuclear elevada para proteína chromosome segregation like 1. Entre os pacientes que apresentavam metástase linfonodal cervical, 18 pacientes apresentaram coloração nuclear elevada, 9 apresentaram coloração moderada e apenas um paciente apresentou coloração fraca. Nenhum dos pacientes com metástase apresentou coloração citoplasmática e apenas um paciente no grupo não-metastático mostrou coloração citoplasmática para a proteína chromosome segregation like 1. Houve uma correlação positiva entre a expressão nuclear da proteína chromosome segregation like 1 e a metástase de linfonodo cervical (r = 0,668), que foi estatisticamente significante (p < 0,001). Conclusão: A expressão da proteína chromosome segregation like 1 está correlacionada com metástases linfonodais em casos de câncer glótico T3-T4 e isso pode mudar a abordagem do tratamento cervical de câncer glótico no futuro.

Rehabilitación vocal fisiológica con ejercicios de tracto vocal semiocluido / Physiologic voice rehabilitation with semi-occluded vocal tract exercises

Introducción. Los ejercicios de tracto vocal semiocluido (ETVSO) son herramien-tas utilizadas en la rehabilitación fisiológica de la voz. Los ETVSO son ejercicios vocales producidos por la semioclusión del tracto vocal, a través de una serie de posturas que buscan alargar y/o ocluir el tracto vocal, generando un cambio en el patrón vibratorio de los pliegues vocales, grado de aducción y el patrón respiratorio. Los ETVSO pueden dividirse, según el tipo de semioclusión, en sostenida, transitoria y oscilatoria, así como en ejercicios de mayor resistencia a menor resistencia.Objetivo. Describir los diferentes tipos de ejercicios de tracto vocal semiocluido, el tipo de semioclusión, el grado de resistencia y sus efectos en los pliegues vocales, patrón respiratorio y configuración del tracto vocal. Metodología. Se realizó una revisión de la literatura en las bases de datos PubMed, Medline y Science Direct, usando los siguientes términos: "Semi-Occluded Vocal Tract Postures", "tract vocal semiocclude" y "ejercicios de tracto vocal semiocluido". Se utilizaron operadores booleanos "AND" y "OR" para especificar la búsqueda.Resultados. Los beneficios de estos ejercicios impactan positivamente en variables aerodinámicas, en la función glótica y en la configuración del tracto vocal. Conclusiones. Los ejercicios de tracto vocal semiocluido son una familia de ejerci-cios vocales producidos por semioclusión sostenida, transitoria y oscilatoria del tracto vocal, a través de una serie de posturas que buscan alargar y/o ocluir el tracto vocal, cuyos beneficios impactan positivamente los pliegues vocales y el tracto vocal

Introduction. Semi-occluded vocal tract exercises (SOVTE) are tools used in physiologic voice rehabilitation. Semi-occluded vocal tract exercises are vocal exer-cises produced by the semi-occlusion of the vocal tract through a series of postures that seek to lengthen and/or occlude the vocal tract, generating a change in the vibratory pattern of vocal folds, degree of vocal folds adduction, and the respira-tory pattern. SOVTE can be divided, according to the type of semi-occlusion, into sustained, transient and oscillatory, as well as exercises with high and low degree of airflow resistance.Objective. To describe the different types of semi-occluded vocal tract exercises, the type of semi-occlusion, the type of resistance, and their effects on the vocal folds, respiratory pattern, and configuration of the vocal tract.Methodology. A literature review was performed in the PubMed, Medline, and Science Direct databases, using the following terms: "Semi-occluded vocal tract pos-tures", "Semi-occluded vocal tract" and "Semi-occluded vocal tract exercises". Boo-lean operators "AND" and "OR" were used to specify the search.Results. The benefits of these exercises positively impact aerodynamic variables, glottal function, and configuration of the vocal tract.Conclusions. The semi-occluded vocal tract exercises are a family of vocal exerci-ses produced by the sustained, transitory, and oscillatory semi-occlusion of the vocal tract, through a series of postures that seek to lengthen and/or occlude the vocal tract, whose benefits positively impact on vocal folds and vocal tract.

Voice analysis of early glottic carcinoma treated by carbon dioxide laser / 临床耳鼻咽喉头颈外科杂志

Objective@#The aim of this study is to investigate the effect of CO2 laser cordectomy on the voice of early glottic carcinoma. @*Method@#A retrospective analysis of 40 patients who underwent CO2 laser treatment early glottis preoperative clinical data of postoperative laryngeal cancer patients, patients with postoperative recurrence rate, survival rate, and the postoperative complications of patients with preoperative and postoperative laryngoscopy, voice disorders index（voice handicap index, VHI） simplified Chinese version（VHI 13） rating scale, affecting the stability sound quality postoperatively in patients with laryngeal cancer were discussed. @*Result@#All patients underwent voice reexamination 8-97 months after surgery, and the survival rate was 100%, no local recurrence and no obvious postoperative complications. Compared with the healthy control group, there were statistically significant differences in the four indicators F0（fundamental frequency）, Jitter（fundamental frequency perturbation）, Shimmer（amplitude perturbation） and MPT（maximum pronunciation time）, suggesting that CO2 laser surgery resulted in significant changes in acoustic parameters. Jitter and Shimmer indexes in the pre involved combined group were statistically significant different from those in the non involved combined group, suggesting that the sound quality of the pre involved combined group was worse in the postoperative stability period. The VHI score indicated that most patients with early glottic cancer were in severe voice disorder before operation and most were in moderate voice disorder after operation. Compared with the healthy control group, the VHI score and total score of the healthy control group were lower in terms of physiology, psychology and emotion. Compared with the healthy control group, the VHI score and physiology of the early glottic laryngeal cancer patients were lower in the early glottic laryngeal cancer patients before and after surgery, and they were statistically significant. @*Conclusion@#CO2 laser surgery for early glottic cancer, the overall survival rate of patients, low recurrence rate, fewer complications, CO2 laser surgery led to significant changes in acoustic parameters, postoperative sound quality and whether the involvement of pre-associated factors; The total score of VHI and physiological score of early glottic carcinoma patients after CO2 laser operation were better than those before operation.

Voice analysis of early glottic carcinoma treated by carbon dioxide laser / 临床耳鼻咽喉头颈外科杂志

The aim of this study is to investigate the effect of CO2 laser cordectomy on the voice of early glottic carcinoma. A retrospective analysis of 40 patients who underwent CO2 laser treatment early glottis preoperative clinical data of postoperative laryngeal cancer patients, patients with postoperative recurrence rate, survival rate, and the postoperative complications of patients with preoperative and postoperative laryngoscopy, voice disorders index（voice handicap index, VHI） simplified Chinese version（VHI 13） rating scale, affecting the stability sound quality postoperatively in patients with laryngeal cancer were discussed. All patients underwent voice reexamination 8-97 months after surgery, and the survival rate was 100%, no local recurrence and no obvious postoperative complications. Compared with the healthy control group, there were statistically significant differences in the four indicators F0（fundamental frequency）, Jitter（fundamental frequency perturbation）, Shimmer（amplitude perturbation） and MPT（maximum pronunciation time）, suggesting that CO2 laser surgery resulted in significant changes in acoustic parameters. Jitter and Shimmer indexes in the pre involved combined group were statistically significant different from those in the non involved combined group, suggesting that the sound quality of the pre involved combined group was worse in the postoperative stability period. The VHI score indicated that most patients with early glottic cancer were in severe voice disorder before operation and most were in moderate voice disorder after operation. Compared with the healthy control group, the VHI score and total score of the healthy control group were lower in terms of physiology, psychology and emotion. Compared with the healthy control group, the VHI score and physiology of the early glottic laryngeal cancer patients were lower in the early glottic laryngeal cancer patients before and after surgery, and they were statistically significant. CO2 laser surgery for early glottic cancer, the overall survival rate of patients, low recurrence rate, fewer complications, CO2 laser surgery led to significant changes in acoustic parameters, postoperative sound quality and whether the involvement of pre-associated factors; The total score of VHI and physiological score of early glottic carcinoma patients after CO2 laser operation were better than those before operation.

Learning curve for endoscopic evaluation of vocal folds lesions with narrow band imaging / Curva de aprendizado para avaliação endoscópica de lesões de pregas vocais com imagem de banda estreita

Abstract Introduction: The endoscopic methods are progressing and becoming more common in routine clinical diagnosis in the field of otorhinolaryngology. Relatively large amount of researches have proved high accuracy of narrow band imaging endoscopy in differentiating benign and malignant lesions within vocal folds. However, little is known about learning curve in narrow band imaging evaluation of laryngeal lesions. Objective: The aim of this study was to determine the learning curve for the narrow band imaging evaluation of vocal folds pathologies depending on the duration of the procedure. Methods: Records of 134 narrow band imaging that were analyzed in terms of the duration of the procedure and the accuracy of diagnosis confirmed by histopathological diagnosis were enrolled in the study. The narrow band imaging examinations were performed sequentially by one investigator over a period of 18 months. Results: The average duration of narrow band imaging recordings was 127.82 s. All 134 studies were divided into subsequent series of several elements. An evident decrease in time of investigation was noticed between 13th and 14th series, when the examinations were divided into 5 elements series, which corresponds to the difference between 65th and 70th subsequent narrow band imaging examination. Parallel groups of 67 examinations were created. Group 1 included 1st to 67th subsequent narrow band imaging examination; Group 2 - 68th to 134th narrow band imaging examinations. The non-parametric U Mann-Whitney test confirmed statistically significant difference between the mean duration of narrow band imaging examination in both groups 160.5 s and 95.1 s, respectively (p < 10−7). Sensitivity and specificity of narrow band imaging examination in the first group were respectively: 83.7% and 76.7%. In the second group, these indicators amounted 98.1% and 80% respectively. Conclusions: A minimum of 65th-70th narrow band imaging examinations are required to reach a plateau phase of the learning process in assessment of glottis lesions. Analysis of learning curves is useful for the development of training programs and determination of a mastery level.

Resumo Introdução: Os métodos endoscópicos estão progredindo e se tornando comuns no diagnóstico clínico de rotina também na otorrinolaringologia. Um número relativamente grande de pesquisas demonstrou alta precisão na endoscopia com imagem de banda estreita na diferenciação de lesões benignas e malignas nas pregas vocais. Entretanto, pouco se sabe sobre a curva de aprendizado na avaliação da de banda estreita de lesões laríngeas. Objetivo: Determinar a curva de aprendizado para a avaliação por imagem de banda estreita das afecções das pregas vocais, de acordo com a duração do procedimento. Método: Foram incluídos no estudo 134 registros de imagens de banda estreita analisadas em termos da duração do procedimento e da acurácia do diagnóstico confirmado pelo diagnóstico histopatológico. Os exames com imagem de banda estreita foram feitos sequencialmente por um investigador por 18 meses. Resultados: A duração média dos registros de imagem de banda estreita foi de 127,82s. Todos os 134 estudos foram divididos em séries subsequentes de vários elementos. Uma evidente diminuição no tempo de investigação foi observada entre as séries 13 e 14, quando os exames foram divididos em séries de cinco elementos, o que corresponde à diferença entre o 65° e 70° exames de imagem de banda estreita subsequentes. Foram criados grupos paralelos de 67 exames. O grupo 1 incluiu o 1° ao 67° exame de imagem de banda estreita subsequente; Grupo 2 - o 68° ao 134° exame de imagem de banda estreita. O teste não paramétrico U de Mann-Whitney confirmou uma diferença estatisticamente significante entre a duração média do exame de imagem de banda estreita em ambos os grupos de 160,5s e 95,1s, respectivamente (p < 10-7). A sensibilidade e especificidade do exame de imagem de banda estreita no primeiro grupo foram, respectivamente: 83,7% e 76,7%. No segundo grupo, esses indicadores foram 98,1% e 80%, respectivamente. Conclusões: Um mínimo de 65 a 70 exames de imagem de banda estreita é necessário para se atingir a fase de estabilização (plateau) do processo de aprendizado na avaliação de lesões de glote. A análise das curvas de aprendizado é útil para o desenvolvimento de programas de treinamento e determinar o n.

Patterns of failure for early-stage glottic carcinoma: 10 years' experience in conformal radiotherapy era

Purpose: Larynx cancer is the most common head-and-neck cancer in Turkey. Vocal cords are involved nearly 70%–80% of laryngeal carcinomas. We aim to present our 10 years' experience and failure patterns of the patients with T1 and T2 glottic laryngeal carcinoma by same manner, technique, doses, and physician in conformal radiotherapy (RT) era. Methods: Between January 2005 and December 2015, a total of 143 patients treated with definitive RT for early-stage glottis laryngeal cancer were selected. The total dose was 65.25 Gy in 29 fractions. Results: The median follow-up time was 64 (range: 12–150) months. All of the patients had a complete clinical response to the treatment. A 5-year local control (LC) rates were 84.5%, 91.8%, 74%, and 56% for overall, T1a, T1b, and T2, respectively. Ultimate LC rates (after salvage treatment) for 5 years were 90%, 95%, 92%, and 75% for overall, T1a, T1b, and T2, respectively. Regional neck control for the whole group was 92% for 5 years. After the initial RT, a total of 22 (15.4%) patients had disease recurrence at any site of the neck or larynx. Median time to disease recurrence was 59.5 months (range: 5–150). Conclusion: This study represents a large and long-term analysis of early-stage glottic carcinoma treated by same manner, technique, doses, and physician in conformal RT era. Definitive RT provides a high LC rate, tolerable toxicity, and favorable voice quality. Extension beyond the vocal cords and T2 stage are the most important unfavorable prognostic factors regarding LC

The role of intraoperative narrow-band imaging in transoral laser microsurgery for early and moderately advanced glottic cancer / O papel da imagem de banda estreita intraoperatória na microcirurgia transoral a laser para câncer glótico inicial e moderadamente avançado

Abstract Introduction: Trans-oral laser microsurgery is an established technique for the treatment of early and moderately advanced laryngeal cancer. Objective: The authors intend to test the usefulness of narrow-band imaging in the intraoperative assessment of the larynx mucosa in terms of specifying surgical margins. Methods: Forty-four consecutive T1-T2 glottic cancers treated with trans-oral laser microsurgery Type I-VI cordectomy were presented. Suspected areas (90 samples/44 patients) were biopsied under the guidance of narrow-band imaging and white light and sent for frozen section. Results: Our study revealed that 75 of 90 (83.3%) white light and narrow-band imaging-guided samples were histopathologically positive: 30 (40%) were confirmed as carcinoma in situ or invasive carcinoma and 45 (60%) as moderate to severe dysplasia. In 6 patients mucosa was suspected only in narrow-band imaging, with no suspicion under white light. Thus, in these 6 patients 18/90 (20%) samples were taken. In 5/6 patients 16/18 (88.8%) samples were positive in frozen section: in 6/18 (33.3%) carcinoma (2 patients), 10/18 (66.6%) severe dysplasia was confirmed (3 patients). In 1 patient 2/18 (11.1%) samples were negative in frozen section. Presented analysis showed, that sensitivity, specificity and accuracy of white light was 79.5%, 20% and 71.1% respectively, while narrow-band imaging was 100%, 0.0% and 85.7%, respectively. Conclusion: The intraoperative use of narrow-band imaging proved to be valuable in the visualization of suspect areas of the mucosa. Narrow-band imaging confirms the suspicions undertaken in white light and importantly, it showed microlesions beyond the scope of white light.

Resumo Introdução: A microcirurgia transoral a laser é uma técnica bem estabelecida para o tratamento de câncer de laringe inicial e moderadamente avançado. Objetivo: Verificar a utilidade da imagem de banda estreita na avaliação intraoperatória da mucosa laríngea na especificação das margens cirúrgicas. Método: Foram avaliados 44 cânceres glóticos T1-T2 consecutivos, tratados com cordectomia Tipo I-VI, por microcirurgia transoral a laser. As áreas suspeitas (90 amostras/44 pacientes) foram submetidas a biopsia e avaliadas através de imagens de banda estreita e luz branca e enviadas para cortes por congelação. Resultados: Nosso estudo revelou que 75 (83,3%) das 90 amostras apresentaram histopatologia positiva na análise com luz branca e imagens de banda estreita: 30 (40%) foram confirmadas como carcinoma in situ ou carcinoma invasivo e 45 (60%) como displasia moderada a grave. Em seis pacientes, a mucosa apresentou-se suspeita apenas na imagem de banda estreita, sem suspeita sob luz branca. Assim, nesses seis pacientes 18/90 (20%) amostras foram colhidas. Em 5/6 pacientes, 16/18 (88,8%) amostras mostraram resultado positivo na análise de congelação: em 6/18 (33,3%) amostras foi confirmado carcinoma (dois pacientes) e em 10/18 (66,6%) foi confirmada displasia grave (três pacientes). Em um paciente, 2/18 (11,1%) as amostras mostraram resultado negativo na congelação. A análise apresentada mostrou que a sensibilidade, a especificidade e a acurácia da luz branca foram de 79,5%, 20% e 71,1%, respectivamente, enquanto a imagem de banda estreita apresentou como resultados 100%, 0,0% e 85,7%, respectivamente. Conclusão: O uso intraoperatório de imagem de banda estreita provou ser valioso na identificação de áreas suspeitas da mucosa, confirmou as suspeitas verificadas na análise com luz branca e, o que é mais importante, identificou microlesões além do alcance da luz branca.

A Clinical Study on Early Glottic Carcinoma Treated with Radiotherapy and Salvage Surgery for Recurrence

Background: Early glottic cancers are treated effectively with radiation or surgery but recurrence is a possibility which requireseither salvage surgery or radiotherapy (RT) depending on the initial treatment modality adopted. Conservation surgery is feasiblein approximately one-third of these recurrent cancers. Endoscopic resections using a CO2 laser or open partial laryngectomyare the current options. Similarly, if initial surgery was used to treat glottic cancers (i) repeated RT with or without chemotherapy,(ii) salvage surgery, (iii) supportive treatment, and/or (iv) palliative chemotherapy is the choices of treatment.Aim of the Study: The aim of the study was to clinically assess the result of RT as initial treatment in the control of squamous cellcarcinoma (SCC) of vocal cord (T1) lesions and undertaking salvage surgery (endoscopic or open) when there is a recurrence.Materials and Methods: Retrospectively medical records of 49 patients were analyzed with T1 SCC of the glottis in which RTwas an initial treatment with a follow-up period of 5 years.Observations and Results: The rate of recurrence after RT was 7/49 (14.28%) of the cases, mean diagnosis interval was31.8 ± 8.75 months. 2/7 (28.57%) patients underwent salvage endoscopic surgery (transmuscular Cordectomy), 3/7 (42.85%)patients underwent open surgery and excision of the tumor and the vocal cord (Horizontal partial Laryngectomy). 1/7 (14.28%)patient was treated with total laryngectomy due to a new recurrence.Conclusions: The recurrence rate was 14.28% in this study of treatment of early cancers of vocal cords (T1) by RT which ishigh when compared to the literature. RT can be a treatment option, but the patient must be aware that higher cure rates canbe achieved through surgery. Partial laryngectomy was more effective for salvage surgery

Effect of Omaha system measures combined with voice training in the treatment of patients with functional vocal dyspraxia caused by glottic insufficiency / 中国基层医药

Objective To explore the effect of Omaha system combined with voice training in the treatment of patients with functional vocal dyspraxia caused by incomplete glottic closure. Methods From January 2017 to December 2017,eighty-eight patients with vocal dystonia due to glottic insufficiency who were treated in the Second Hospital of Shaoxing were randomly divided into control group and observation group by random number table method, with 44 cases in each group.The control group was treated with voice training.The observation group was given Omaha system measures on the basis of treatment in the control group.After 8 weeks,the therapeutic effects,GRBAS index scores,VHI scores,changes in acoustic parameters,and laryngoscope scores were compared between the two groups. Results After treatment,the total effective rate of the observation group (90.91% ) was significantly higher than that of the control group(59.09% ) (χ2 =9.317,P<0.05).After treatment,the scores of total deafness,roughness and other indicators were significantly reduced in both two groups,and the scores of GRBAS in the observation group were significantly lower than those in the control group(t=8.674,P<0.001;t=2.169,P=0.032;t=2.489,P=0.014;t=32.832,P<0.001;t=9.381,P<0.001).After treatment,the index scores and total VHI scores of both two groups were significantly decreased,and the scores of the observation group were significantly lower than those of the control group(t=2.222,P =0.028;t =3.144,P =0.002;t =2.003,P =0.048;t =5.763,P <0.001). After treatment,the maximum phonation time(MPT),basic frequency( Jitter),and lowest sound intensity( I-Low) were significantly reduced in the two groups, which in the observation group were significantly lower than those in the control group( t =4.037,P <0.001;t =4.789,P <0.001; t =4.717,P <0.001). The highest basic frequency (F0-High) and DSI index significantly increased in both two groups,which in the observation group were signifi-cantly higher than those in the control group(t=4.497,P<0.001;t=4.794,P<0.001).Conclusion The combi-nation of Omaha system measures and voice training can significantly improve functional vocal disturbances caused by glottic insufficiency,significantly improve the quality of patients＇voices,improve glottic closure,and contribute to the recovery of patients＇voices.It is worthy of promotion in clinical practice.

A Case Report of Emergency Cricothyroidotomy Due to Tracheal Intubation Failure in the Patient with Posterior Glottic Stenosis Due to Inhalation Burn / 계명의대학술지

Injuries of the larynx are common in patients with a history of inhalation burns. When anesthesia is performed in such patients, the possibility of tracheal intubation should be thoroughly checked in advance, and preparation should be made in case of possible failure. 73-year-old woman who underwent laser cordotomy due to posterior glottic stenosis due to inhalation burn. Her height and weight were 140 cm and 58.9 kg. We proceeded anesthesia, because preoperative fiberoptic laryngoscopy and otolaryngology consultation showed that tracheal intubation was possible. However, the intubation failed and the manual ventilation was not performed afterwards, so the cricothyroidotomy was performed as an emergency. Anesthesia in patients with posterior glottic stenosis due to inhalation burns requires a great deal of attention and, above all, thorough evaluation in order to confirm the possibility of tracheal intubation. If this is not possible, you should look for alternatives and be prepared, and even if you think it's possible, try anesthesia with thorough preparation for the possible failure.

Unanticipated Difficult Intubation in Patient with Undiagnosed Posterior Glottic Stenosis

Posterior glottic stenosis (PGS) is frequently caused by prolonged intubation complications, which may limit the movement of the vocal cords and obstruct airway obstruction. Despite of a life-threatening condition, it might be overlooked in asymptomatic individual. A 63-year-old female was scheduled for arthroscopic rotator cuff repair. The patient had experienced 2 times of intubation and organophosphate poisoning for suicide. Both of 7.0- and 6.5-mm inner diameter endotracheal tubes could not be passed vocal cords. After two failed attempts at intubation, adhesion of posterior part of vocal cord was revealed. We stopped the tracheal intubation and called the otolaryngologist, and adhesiolysis was performed under direct laryngosope. Thereafter, endotracheal intubation was performed successfully with 6.5-mm endotracheal tube.

A Prospective Study Of Laryngotracheal Trauma And It‘S Management

BACKGROUND: Traumatic injuries of the larynx are diverse, uncommon, and potentially life threatening. Laryngotracheal trauma can be oadly divided into External trauma , which can be blunt or penetrating trauma , and internal trauma , which can be iatrogenic , thermal , caustic and foreign body injuries .external trauma which can be blunt trauma caused by motor vehicle accidents , suicidal or homicidal strangulation and penetrating trauma caused by suicidal or homicidal cut throat injuries . Iatrogenic injuries are most common cause of internal trauma . If not adequately treated these injuries lead to significant morbidity such as dysphonia , airway stenosis , aspiration and sometimes may lead to death . Laryngotracheal trauma is often associated with concomitant cervical or intracranial trauma or with multisystem poly trauma . External laryngeal trauma is rare. It has a population incidence of 1 in 137,000 in adults and accounts for 0.5% of trauma admissions in children. Incidence of postintubation laryngotracheal stenosis requiring surgical correction is 1 in 204,000 in adults and 4.9 in 100,000 in children.Laryngeal webs , intubation granulomas , laryngeal injuries while intubation , inhalational and ingestion injuries are very rare in incidence 1 . MATERIALS AND METHODS: 20 patients who presented with external and internal laryngotracheal trauma to casualty department in Government general hospital, Kakinada, Andhra Pradesh state , during the period between June 2015 to September 2017. A detailed history was taken with emphasis on trauma.Clinical features were noted and patients were appropriately investigated . RESULTS: The age of patients in present study varied from 12-70 years . Majority of patients are present in 26-40 years age group (55%) . Among the 20 cases in our study 13 cases were males (65%) and 7 cases were females (35%). In our study of 20 patients 14 patients sustained injuries due to external trauma(70%) and 6 patients presented with internal trauma of larynx(30%) due to prolonged intubation . In our study 6 of the 20 patients presented with laryngeal stenosis due to prolonged intubation among them 3 patients presented with subglottic stenosis 2 with glottic stenosis and 1 tracheal stenosis. Amongst them 9 of 14 patients were due to penetrating neck injuries(64.3%) and 5 of 14 are due to blunt neck trauma (35.7%) . 7 of 9 patients knife infected wounds and 2 due to motor vehicle accident. 2 of 5 patients in blunt trauma are due to hanging 2 are due to strangulation and one is due to bullgore injury. Most commonly presented with pain (70%) , dyspnoea (50%) , hoarseness (45%) . stridor was present mostly in laryngeal stenosis patients. The present study 15 of 20 patients airway was initially managed with the help of tracheostomy in 3 of 20 patients with intubation and 2 patients were under observation. There was a recurrence in one case of subglottic stenosis and endoscopic laser exicision was done again .In further followup there was no recurrence. CONCLUSION: In conclusion, we believe that the management of injuries to the larynx and trachea can be individualized based on the clinical presentation and mechanism of injury. Early diagnosis and stratification of treatment based on the initial history, physical findings has improved outcomes. Our goal remains preservation of life with restoration of a normal airway and voice. Patients with blunt injuries can often be managed conservatively with close monitoring in the intensive care unit. Penetrating injuries will often have associated injuries or airway compromise that will mandate operative exploration.

Prognostic role of margin status in open and CO2 laser cordectomy for T1a-T1b glottic cancer / Papel prognóstico do estado da margem cirúrgica na cordectomia aberta e com laser de CO2 em câncer glótico T1a-T1b

Abstract Introduction Cordectomy by laringofissure and transoral laser surgery has been proposed for the treatment of early glottic cancer. Objectives The aim of this retrospective study was to evaluate the prognostic value of margin status in 162 consecutive cases of early glottic carcinoma (Tis-T1) treated with CO2 laser endoscopic surgery (Group A) or laryngofissure cordectomy (Group B), and to compare the oncologic and functional results. Methods Clinical prognostic factors, local recurrence rate according to margin status, overall survival and disease-free survival were analyzed. Results Margin status is related to recurrence rate in both groups (p < 0.05) without significant differences between open and laser cordectomy (p > 0.05). The 5 years overall survival and disease-free survival were respectively 90.48% and 85.71% in Group A; 88.14% and 86.44% in Group B (p > 0.05). Lower tracheostomy rate, earlier recovery of swallowing function and shorter hospital stay were observed in Group A (p < 0.05). Conclusions Margin status has a prognostic role in T1a-T1b glottic cancer. Transoral laser surgery showed similar oncologic results of open cordectomy, with better functional outcomes.

Resumo Introdução Cordectomia por laringofissura e cirurgia transoral a laser têm sido propostas para o tratamento do câncer glótico inicial. Objetivos O objetivo desse estudo retrospectivo foi avaliar o valor prognóstico do estado da margem em 162 casos consecutivos de carcinoma glótico inicial (Tis-T1) tratado com cirurgia endoscópica a laser de CO2 (Grupo A) ou cordectomia por laringofissura (Grupo B) e comparar resultados oncológicos e funcionais. Método Foram analisados fatores prognósticos clínicos, taxa de recorrência local de acordo com o estado da margem, sobrevida global e sobrevida livre de doença. Resultados O estado de margem está relacionado à taxa de recorrência em ambos os grupos (p < 0,05) sem diferenças significativas entre cordectomia aberta e cirurgia a laser (p > 0,05). A sobrevida global de cinco anos e a sobrevida livre de doença foram, respectivamente, 90,48% e 85,71% no Grupo A; 88,14% e 86,44% no Grupo B (p > 0,05). Menor taxa de traqueostomia, recuperação mais rápida da função de deglutição e menor tempo de internação foram observados no Grupo A (p < 0,05). Conclusões O estado da margem tem papel prognóstico no câncer glótico T1a-T1b. A cirurgia a laser transoral mostrou resultados oncológicos semelhantes aos da cordectomia aberta, com melhores resultados funcionais.

Comparison of Truviewscope and C-Mac Video Laryngoscope with the Conventional Macintosh Laryngoscope in Improving the Glottic View during Endotracheal Intubation

Background: In anesthetic practice, the introduction of multiple novel laryngoscopes has simplified visualization of the vocal cords and has reduced the complications arising due to difficult or failed tracheal intubation Both Truview scope and C-Mac video laryngoscope have been reported to provide a comparable or superior glottic view on comparison with conventional Macintosh laryngoscope Materials and methods: A randomized controlled study was conducted in 100 subjects scheduled for elective surgery equally divided into 2 groups Conventional Macintosh laryngoscopy was done initially in all subjects enrolled for the study For the Glottic view, One Group (n=50) underwent Truview laryngoscopy while the other (n=50) underwent C-Mac video laryngoscopy Results: The improvement in glottic view from original MCL (Modified Cormack & Lehane) grading obtained from Macintosh laryngoscope was 40% (n=23) in Truview compared to 46% (n=23) in CMac video laryngoscope while downgrading of view was observed in 10% (n=5) in group– T compared to none in C-Mac video laryngoscope There were no statistically significant difference in Intubation Difficulty Scale (IDS) scores between the groups (P = 0072) The mean duration of time R Vimal, A Sivanoli Comparison of Truviewscope and C-Mac Video Laryngoscope with the Conventional Macintosh Laryngoscope in Improving the Glottic View during Endotracheal Intubation IAIM, 2018; 5(12): 125-133 Page 126 for endotracheal intubation with C-Mac video laryngoscope (2310 seconds) was significantly shorter compared with Truview laryngoscope (3126 seconds) Conclusions: There was an improvement in view of the glottis in both Truview and C-Mac video laryngoscope from the initial Macintosh laryngoscope view But C-Mac video laryngoscope offered better view improvement and also required a shorter time for intubation compared to Truview laryngoscope

Evaluation of swallowing function after cricohyoidoepiglottopexy / 局解手术学杂志

Objective To investigate the evaluation ways and effects of swallowing function after cricohyoidoepiglottopexy(CHEP). Methods Selected 92 patients of glottic carcinoma who were admitted into hospital from February 2014 to January 2017,and all the patients were given cricohyoidoepiglottopexy(CHEP)therapy and function reconstruction.Modified barium swallow(MBS),modified penetration as-piration scale(MPAS),and fiberoptic endoscopic evaluation of swallowing(FEES)were applied after the surgery.And the prognosis of patients was followed up.Results There was one patient who was not able to extubate,and the extubation time of tracheaostomy tube and stomach tube were respectively(12.04 ±5.42)week and(8.00 ±2.19)d among the remaining 91 cases.Three months after operation,the laryngeal function were good in 84 cases,moderate in 6 cases and poor in 2 cases,the incidence of complications was 6.5%.The fundamental frequency and fundamental frequency perturbation three months after operation were significantly lower than thos before operation(P<0.05). With the extension of postoperative time,the MPAS score of patients with MBS and FEES evaluation were obviously decreased(P<0.05). The MBS assessment score were respectively(3.87 ±0.98)points,(1.64 ±0.65)points,(1.09 ±0.33)points at 15 days,30 days and 60 days after operation.The FEES evaluation score were respectively(3.27 ±1.33)points,(1.73 ±1.11)points,(1.18 ±0.89)points at 15 days,30 days and 60 days after operation.With the MBS assessment as the gold standard,the sensitivity of FEES assessment to normal,false aspiration and aspiration were 100%,76.7%and 86.7%,respectively,and the specificity were 86.7%,97.1% and 98.3%,respectively. Conclusion The cricohyoidoepiglottopexy and laryngeal defect repair in the treatment of glottic carcinoma can effectively preserve the laryn -geal function,reduce the incidence of postoperative complications,improve pronunciation function,and the FEES and MBS evaluation of laryn-geal function have good accuracy,and they have good clinical significance to understand the degree of postoperative aspiration.