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S180 – Change of Mucosal Immunity Due to Radiotherapy to Larynx
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Otolaryngology-Head and Neck Surgery, Vol 139, No 2S1, August 2008
primary hyperparathyroidism in order to further refine the focused technique. Its utility as the standard preoperative localization modality is not yet established and requires further investigation. Evaluation of differences in facility utilization with CT-MIBI image fusion and conventional sestamibi imaging may be helpful in determining its role in preoperative localization for hyperparathyroidism. S179 – Voice Self-evaluation after Treatment for T1 Glottic Cancer Faustino Nunez, MD (presenter); Maria Jesus Caminero, MD; Jose-Luis Llorente-Pendas, MD; Carlos Suarez-Nieto, MD OBJECTIVES: 1) To present the objective and subjective analysis of voice quality following treatment of an early epidermoid glottic carcinoma. 2) Results from the objective evaluation of the voice, along with the self-evaluation of voice quality quantified using the Voice Handicap Index of a group of patients treated with endoscopic laser surgery, are compared with patients treated with radiotherapy. METHODS: We performed an objective voice evaluation, as well as a physical, emotional, and functional well-being assessment of 19 patients treated with laser surgery and 18 patients treated with radiotherapy. The data obtained was gathered in the statistical database SPSS 12.0. The statistical analysis used was the “Student t test” in order to compare averages and the Chi-squared test for comparing proportions. The statistical differences were considered significant when p was lower than 0.05. RESULTS: Voice quality is affected both by surgery and radiotherapy. Voice parameters only show differences in the maximum phonation time between both treatments (p ⬍ 0,005). Patients Self-Perception Analysis (Voice Handicap Index) Upon completing the comparison between the two groups, the statistical difference is significant, in favor of the radiotherapy patients in functional and emotional ratings, as well as the global scores (p⬍0,005). No significant differences were found in the physical scales. CONCLUSIONS: There is a reduced impact in patient’s perception of voice quality after radiotherapy, despite no significant differences in vocal quality between radiotherapy and laser cordectomy. S180 – Change of Mucosal Immunity Due to Radiotherapy to Larynx Tadashi Nakashima, MD, PhD (presenter); Hideichiro Tomita, MD OBJECTIVES: Radiation-induced xerostomia is known to be a significant complication in head and neck cancer patients receiving radiation. As the larynx is endowed with a rich
supply of glands, the survey of the secretory immunoglobulins as well as the glandular distribution in human larynx should provide a valuable baseline for understanding the immunological status of the larynx. The aim of this study is to assess the influence of radiation on the larynx in patients who received radiotherapy on the neck. METHODS: Laryngeal fluids or tissues were obtained from 111 human adults who received surgery or radiation therapy for hypopharyngeal or laryngeal cancer. From patients who had to undergo a total laryngectomy, the larynges were examined histopathologically. The change of the glandular distribution was measured using the image analyzing system. The levels of immunoglobulins, as well as the concentration of laryngeal glands, were compared between individuals with or without radiotherapy. RESULTS: The laryngeal secretion contained immunological factors such as secretory IgA. The level of SIgA fell to low levels in patients with previous radiation therapy. The glandular acini are often replaced with fibrous connective tissue. The density of the glands decreased and the ratio of serous-type glandular cells decreased. CONCLUSIONS: These results indicate that not only the voice function, but also the local defense function of the larynx, might be impaired after radiotherapy. S181 – Injection Laryngoplasty with Hyaluronic Acid David P Lau, BMedSc, FRCS (presenter); Gwyneth Lee, MD; Seng Mun Wong, MD; Yiong Huak Chan, MD; Nam Guan Tan, MD; Linda Rammage, MD; Murray Morrison, MD OBJECTIVES: To determine if particle size affects durability of medialisation in patients undergoing injection laryngoplasty (IL) with hyaluronic acid (HA) for unilateral vocal cord paralysis (UVCP). Hypothesis: Larger particle-size HA persists longer after injection to produce a more durable vocal result. METHODS: Study Design: Prospective randomized controlled single-blind trial. Years conducted: 2005-2007. Condition studied: UVCP. Subjects: Patients over the age of 18 requiring medialisation for UVCP. Setting: Outpatient clinic setting. Intervention: Patients underwent transcutaneous IL with Restylane (small particle-size HA) or Perlane (large particle-size HA). Outcome measurement: The Voice Handicap Index (VHI) at 6 months post-injection was the primary outcome measure. Secondary outcomes included videostroboscopic findings, and objective acoustic and aerodynamic measures. Statistical methods: Differences between groups were compared using the Mann Whitney U test and adjusted for age & gender using ANCOVA. RESULTS: 17 patients (8 Restylane, 9 Perlane) were available for follow-up at 6 months. Normalised VHI scores at 6 months after IL were significantly lower in the Perlane group
Otolaryngology-Head and Neck Surgery, Vol 139, No 2S1, August 2008
primary hyperparathyroidism in order to further refine the focused technique. Its utility as the standard preoperative localization modality is not yet established and requires further investigation. Evaluation of differences in facility utilization with CT-MIBI image fusion and conventional sestamibi imaging may be helpful in determining its role in preoperative localization for hyperparathyroidism. S179 – Voice Self-evaluation after Treatment for T1 Glottic Cancer Faustino Nunez, MD (presenter); Maria Jesus Caminero, MD; Jose-Luis Llorente-Pendas, MD; Carlos Suarez-Nieto, MD OBJECTIVES: 1) To present the objective and subjective analysis of voice quality following treatment of an early epidermoid glottic carcinoma. 2) Results from the objective evaluation of the voice, along with the self-evaluation of voice quality quantified using the Voice Handicap Index of a group of patients treated with endoscopic laser surgery, are compared with patients treated with radiotherapy. METHODS: We performed an objective voice evaluation, as well as a physical, emotional, and functional well-being assessment of 19 patients treated with laser surgery and 18 patients treated with radiotherapy. The data obtained was gathered in the statistical database SPSS 12.0. The statistical analysis used was the “Student t test” in order to compare averages and the Chi-squared test for comparing proportions. The statistical differences were considered significant when p was lower than 0.05. RESULTS: Voice quality is affected both by surgery and radiotherapy. Voice parameters only show differences in the maximum phonation time between both treatments (p ⬍ 0,005). Patients Self-Perception Analysis (Voice Handicap Index) Upon completing the comparison between the two groups, the statistical difference is significant, in favor of the radiotherapy patients in functional and emotional ratings, as well as the global scores (p⬍0,005). No significant differences were found in the physical scales. CONCLUSIONS: There is a reduced impact in patient’s perception of voice quality after radiotherapy, despite no significant differences in vocal quality between radiotherapy and laser cordectomy. S180 – Change of Mucosal Immunity Due to Radiotherapy to Larynx Tadashi Nakashima, MD, PhD (presenter); Hideichiro Tomita, MD OBJECTIVES: Radiation-induced xerostomia is known to be a significant complication in head and neck cancer patients receiving radiation. As the larynx is endowed with a rich
supply of glands, the survey of the secretory immunoglobulins as well as the glandular distribution in human larynx should provide a valuable baseline for understanding the immunological status of the larynx. The aim of this study is to assess the influence of radiation on the larynx in patients who received radiotherapy on the neck. METHODS: Laryngeal fluids or tissues were obtained from 111 human adults who received surgery or radiation therapy for hypopharyngeal or laryngeal cancer. From patients who had to undergo a total laryngectomy, the larynges were examined histopathologically. The change of the glandular distribution was measured using the image analyzing system. The levels of immunoglobulins, as well as the concentration of laryngeal glands, were compared between individuals with or without radiotherapy. RESULTS: The laryngeal secretion contained immunological factors such as secretory IgA. The level of SIgA fell to low levels in patients with previous radiation therapy. The glandular acini are often replaced with fibrous connective tissue. The density of the glands decreased and the ratio of serous-type glandular cells decreased. CONCLUSIONS: These results indicate that not only the voice function, but also the local defense function of the larynx, might be impaired after radiotherapy. S181 – Injection Laryngoplasty with Hyaluronic Acid David P Lau, BMedSc, FRCS (presenter); Gwyneth Lee, MD; Seng Mun Wong, MD; Yiong Huak Chan, MD; Nam Guan Tan, MD; Linda Rammage, MD; Murray Morrison, MD OBJECTIVES: To determine if particle size affects durability of medialisation in patients undergoing injection laryngoplasty (IL) with hyaluronic acid (HA) for unilateral vocal cord paralysis (UVCP). Hypothesis: Larger particle-size HA persists longer after injection to produce a more durable vocal result. METHODS: Study Design: Prospective randomized controlled single-blind trial. Years conducted: 2005-2007. Condition studied: UVCP. Subjects: Patients over the age of 18 requiring medialisation for UVCP. Setting: Outpatient clinic setting. Intervention: Patients underwent transcutaneous IL with Restylane (small particle-size HA) or Perlane (large particle-size HA). Outcome measurement: The Voice Handicap Index (VHI) at 6 months post-injection was the primary outcome measure. Secondary outcomes included videostroboscopic findings, and objective acoustic and aerodynamic measures. Statistical methods: Differences between groups were compared using the Mann Whitney U test and adjusted for age & gender using ANCOVA. RESULTS: 17 patients (8 Restylane, 9 Perlane) were available for follow-up at 6 months. Normalised VHI scores at 6 months after IL were significantly lower in the Perlane group