Effects of head and neck radiation therapy on vocal function

Objective: Radiotherapy (RT) is used to treat a variety of head and neck ma lignancies. The larynx may receive high radiation doses even in the absence of disease. The effects of RT on the nondiseased larynx are unknown. This study will evaluate subjective and objective parameters of vocal function i n patients treated with RT for nonlaryngeal malignancies. Design: Cross-sectional observational study. Methods: Videostroboscopic, aerodynamic, and acoustic analyses were perform ed. Results were compared to age- and gender-matched controls. Self-assessm ent of voice quality was measured using the Voice Handicap Index. Results: A majority of patients demonstrated increased supraglottal activit y (i.e., ventricular fold constriction) during stroboscopic evaluation. Sig nificant differences compared to normative data were found in many aerodyna mic and acoustic parameters. A substantial proportion (27%) of patients rep orted significant voice handicap. Younger patients reported greater handica p, and voice quality was worse with time. Conclusions: Significant objective and subjective changes in vocal function occur in patients radiated for nonlaryngeal head and neck malignancies. Yo ung patients may have the worst impact, and vocal dysfunction may increase with time. A prospective study of this patient population should include a baseline voice quality assessment.