2018 Section 6 - Laryngology, Voice Disorders, and Bronchoesophalogy

Fig. 3. Pre- and postoperative objective measurements of phonation quality. (A) Jitter. (B) Shimmer. (C) Noise-harmonic ratio. (D) Fundamen- tal frequency.

presence of acute or late toxicity was not examined in this study. The presence of severe (grade III) toxicity is rare in early-stage glottic carcinoma treated with defini- tive radiotherapy alone. 14 Mild and moderate (grade I and II, respectively) toxicity is seen in a majority of radiotherapy patients and is typical during and immedi- ately following treatment. 15,16 Grade I laryngeal radio- toxicity includes hoarseness and slight arytenoid edema, whereas grade II includes moderate arytenoid edema

and chondritis, as well as skin erythema and esophagi- tis. 17 A 2017 meta-analysis by Mo et al. of 11 studies comparing functional and oncologic outcomes of TLM versus radiation therapy found significantly improved laryngeal preservation rate and overall survival in the TLM group. 18 However, this analysis did not take into account clinical and demographic factors of each patient group, and the local control rate was not significantly different between the two groups. A study of 75 patients

Fig. 4. Pre-, intra-, and postoperative views of KTP-TLM treatment of T1 glottic carcinoma. (A) Preoperative view of right T1a carcinoma. (B) The KTP laser is used on pulsed mode to ablate the tumor and achieve close margins while minimizing damage to surrounding tissue. (C) Post- operative view at 4 months. This patient is now over 5 years cancer free and maintains his singing voice. KTP 5 potassium titanyl phosphate; TLM 5 transoral laser microsurgery. [Color figure can be viewed in the online issue, which is available at www.laryngoscope.com.]

Laryngoscope 00: Month 2017

Ahmed et al.: KTP Laser vs. Radiation for T1 Glottic Cancer

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