ISSN 2667-7466 | E-ISSN 2667-7474
Original Article
Comparison of Voice Quality and Cost Effectiveness of Endoscopic Cordectomy Using Microdissection Electrodes with Laser Cordectomy and Radiotherapy
1 Department of Otorhinolaryngology, Health Sciences University, Ümraniye Training and Research Hospital, İstanbul, Turkey  
2 Department of Otorhinolaryngology, Marmara University School of Medicine, İstanbul, Turkey  
3 Department of Otorhinolaryngology, Health Sciences University, İstanbul Training and Research Hospital, İstanbul, Turkey  
4 Department of Radiation Oncology, Kartal Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey  
Turk Arch Otorhinolaryngol 2019; 57: 1-6
DOI: 10.5152/tao.2019.4044
Key Words: Early laryngeal cancer, voice quality, radiofrequency ablation, cost effectiveness
Abstract

 

Objective: To compare the acoustic parameters and the cost effectiveness achieved after endoscopic cordectomy using radiofrequency microdissection electrodes (ECRM) with those of transoral laser cordectomy and radiotherapy.

 

Methods: The study included 81 disease-free patients previously treated for early larynx carcinoma (30 with ECRM, 27 with transoral laser cordectomy, 24 with primary radiotherapy). Post-treatment voice analysis was performed in all patients. Additionally, the cost effectiveness of all treatment procedures was calculated.

 

Results: The GRBAS (G: Grade, R: Roughness, B: Breathiness, A: Asthenia, and S: Strain) scale showed a significant difference between the groups (p<0.001). The mean values for perceptive assessment score in the radiotherapy group were significantly lower than those in the ECRM group (p<0.05). There were no significant differences between the ECRM group and the transoral laser cordectomy group in terms of the perceptive assessment scores (p>0.05 for all). Percent jitter, percent shimmer and fundamental frequency (F0) were significantly different in the radiotherapy group than the ECRM and the transoral laser cordectomy groups (p<0.05). Maximum phonation time (MPT) in the radiotherapy group was significantly longer than the ECRM and transoral laser cordectomy groups (p<0.001). There were no significant differences between the ECRM group and the transoral laser cordectomy group in terms of the MPT (p>0.05). The mean cost of the ECRM technique was statistically lower than the other treatment techniques (p<0.05). Moreover, the length of hospital stay after ECRM was statistically significantly shorter than was after laser cordectomy (p<0.05).

 

Conclusion: Objective and perceptive voice analysis after ECRM showed comparable results with transoral laser cordectomy, but poorer results than radiotherapy. Cost effectiveness of ECRM was found to be better than the other two treatment techniques

 

 

 

Amaç: Radyofrekans mikrodisseksiyon elektrot aracılı transoral kordektominin (ECRM) ses kalitesi ve maliyet etkinliğinin lazer kordektomi ve radyoterapi ile karşılaştırılması.

 

Yöntemler: Erken glottik karsinom nedeni ile tedavi edilmiş 81 hasta çalışmaya dahil edildi. (ECRM: 30, transoral lazer kordektomi: 27, primer radyoterapi: 24). Tüm hastaların tedavi sonrası ses analizi yapıldı. Ek olarak, tüm tedavi yöntemlerinin maliyet etkinliği hesaplandı.

 

Bulgular: GRBAS skalası gruplar arasında anlamlı bir fark gösterdi (p<0.001). Radyoterapi grubu için algısal değerlendirme skoru ortalama değerleri ECRM grubundan anlamlı olarak düşüktü (p<0.05). ECRM grubu ile transoral lazer kordektomi grubu arasında algısal değerlendirme skoru açısından anlamlı fark yoktu (p>0.05). Radyoterapi grubunda yüzde jitter, shimmer ve temel ses frekansı (F0) ECRM ve transoral lazer kordektomiye göre anlamlı olarak farklıydı (p<0.05). Radyoterapi grubundaki maksimum fonasyon süresi (MPT) ECRM ve transoral lazer kordektomi gruplarından anlamlı derecede yüksekti (p<0.001). ECRM grubu ile transoral lazer kordektomi grubu arasında MPT açısından anlamlı fark yoktu (p>0.05). ECRM tekniğinin ortalama maliyeti diğer tedavi tekniklerine göre istatistiksel olarak daha düşüktü (p<0.05). Ek olarak, ECRM'den sonra hastanede kalış süresi lazer kordektomiden istatistiksel olarak anlamlı derecede kısaydı (p<0.05).

 

Sonuç: ECRM sonrası objektif ve algısal ses analizinin transoral lazer kordektomiye benzer, ancak radyoterapiden daha kötü olduğu saptandı. ECRM'nin maliyet etkinliğinin diğer tedavi tekniklerinden daha iyi olduğu tespit edildi.

 

Cite this article as: Sürmeli M, Oysu Ç, Şahin Yılmaz AA, Deveci İ, Karabulut B, Sunter AV, et al. Comparison of Voice Quality and Cost Effectiveness of Endoscopic Cordectomy Using Microdissection Electrodes with Laser Cordectomy and Radiotherapy. Turk Arch Otorhinolaryngol 2019; 57(1): 1-6.

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