Vocal function after vertical partial laryngectomy with glottic reconstruction by false vocal fold flap: Durational and frequency measures

Objective: Compare vocal function following vertical partial laryngectomy ( VPL) with or without glottic reconstruction by false vocal fold (FVF) mucos al flap. Study Design: Twenty-seven patients with Tla squamous cell carcino ma (SCC) of the glottis were included in a prospective randomized clinical study. All patients were treated by frontolateral partial laryngectomy (FLP L). Glottic reconstruction with FVF mucosal flap was performed in 14 patien ts at the time of the FLPL, whereas 13 patients had standard FLPL. Il Metho ds: Objective voice assessment was based on computerized acoustic recording s performed before and 1 year after surgery. When possible, additional reco rdings were performed at 3 months, 6 months, and 2 years postoperatively. I ncidence of postoperative granuloma and anterior neoglottic web were noted. Repeated analysis of variance (ANOVA) was used to compare the durational ( maximum phonation time, speech rate) and frequency measurements (average fu ndamental frequency [Fo], standard deviation of Fo, jitter, shimmer, noise- to-harmonics ratio, degree of voice breaks) between patients with or withou t glottic reconstruction postoperative granuloma, and anterior neoglottic w eb. Linear regression was used to study the evolution over time of the dura tional and frequency measurements. Results: Frequency measurements improved with time and were significantly better in patients treated with glottic r econstruction. In addition, glottic reconstruction decreased incidence of p ostoperative granuloma and anterior neoglottic web. Conclusions: The FVF mu cosal Bap technique can improve vocal results in selected cases of Tla SCC of the glottis when FLPL is the adequate surgical treatment.