{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T01:50:40Z","timestamp":1791078640864,"version":"4.1.0"},"reference-count":74,"publisher":"SAGE Publications","issue":"12_suppl","license":[{"start":{"date-parts":[[2002,12,1]],"date-time":"2002-12-01T00:00:00Z","timestamp":1038700800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2002,12]]},"abstract":"<jats:p>Phonosurgical management of early glottic cancer has evolved considerably, but objective vocal outcome data are sparse. A prospective clinical trial was done on 32 patients with unilateral cancer (T1a in 28 and T2a in 4) who underwent ultranarrow-margin resection; 15 had resection superficial to the vocal ligament, and 17 deep to it. The subepithelial infusion technique facilitated selection of these patients for the appropriate procedure. All are cancer-free without radiotherapy or open surgery. Involvement of the anterior commissure (22\/32) or the vocal process (15\/32) of the arytenoid cartilage did not influence local control. Nine of 17 patients had resection of paraglottic musculature, and all underwent medialization reconstruction by lipoinjection and\/or Gore-Tex laryngoplasty. Eight of the 17 had resections deep to the vocal ligament, but without vocalis muscle, and 1 of the 8 underwent medialization. Posttreatment vocal function measures were obtained for all patients. A clear majority of the patients displayed normal values for average fundamental frequency (72%) during connected speech, and normal noise-to-harmonics ratio (75%) and average glottal airflow (91%) measures during sustained vowels. Smaller majorities of patients displayed normal values for average sound pressure level (SPL; 59%) during connected speech and for maximum ranges for fundamental frequency (56%) and SPL (59%). Fewer than half of the patients displayed normal values for sustained vowel measures of jitter (45%), shimmer (22%), and maximum phonation time (34%). Almost all patients had elevated subglottal pressures and reduced values for the ratio of SPL to subglottal pressure (vocal efficiency). There were significant improvements in a majority of patients for most vocal function measures after medialization reconstruction. Normal or near-normal conversation-level voices were achieved in most cases, regardless of the disease depth, by utilization of a spectrum of resection and reconstruction options. These favorable results are based on establishing aerodynamic glottal competency and preserving the layered microstructure of noncancerous glottal tissue.<\/jats:p>","DOI":"10.1177\/0003489402111s1202","type":"journal-article","created":{"date-parts":[[2017,1,6]],"date-time":"2017-01-06T08:54:06Z","timestamp":1483692846000},"page":"3-20","source":"Crossref","is-referenced-by-count":82,"title":["Voice and Treatment Outcome from Phonosurgical Management of Early Glottic Cancer"],"prefix":"10.1177","volume":"111","author":[{"given":"Steven M.","family":"Zeitels","sequence":"first","affiliation":[{"name":"Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon A.","family":"Franco","sequence":"additional","affiliation":[{"name":"Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Hillman","sequence":"additional","affiliation":[{"name":"Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn W.","family":"Bunting","sequence":"additional","affiliation":[{"name":"Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2002,12,1]]},"reference":[{"key":"bibr1-0003489402111S1202","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0347(199707)19:4<342::AID-HED13>3.0.CO;2-B"},{"key":"bibr2-0003489402111S1202","first-page":"244","volume":"4","author":"Solis-Cohen J","year":"1869","journal-title":"Med Rec"},{"key":"bibr3-0003489402111S1202","first-page":"283","volume":"12","author":"Fraenkel B","year":"1886","journal-title":"Arch Klin Chir"},{"key":"bibr4-0003489402111S1202","first-page":"156","volume":"3","author":"Kirstein A","year":"1895","journal-title":"Arch Laryngol Rhinol"},{"key":"bibr5-0003489402111S1202","volume-title":"Autoscopy of the larynx and trachea (direct examination without mirror)","author":"Kirstein A","year":"1897"},{"key":"bibr6-0003489402111S1202","first-page":"277","volume":"26","author":"Killian G","year":"1912","journal-title":"Arch Laryngol Rhinol"},{"key":"bibr7-0003489402111S1202","first-page":"119","volume":"40","author":"Lynch RC","year":"1920","journal-title":"Trans Am Laryngol Assoc"},{"key":"bibr8-0003489402111S1202","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197212000-00009"},{"key":"bibr9-0003489402111S1202","doi-asserted-by":"publisher","DOI":"10.1177\/000348947208100606"},{"key":"bibr10-0003489402111S1202","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-197508000-00003"},{"key":"bibr11-0003489402111S1202","doi-asserted-by":"publisher","DOI":"10.1002\/lary.1978.88.9.1399"},{"key":"bibr12-0003489402111S1202","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(78)90267-2"},{"key":"bibr13-0003489402111S1202","first-page":"239","volume":"21","author":"Hirano M","year":"1975","journal-title":"Otologia (Fukuoka)"},{"key":"bibr14-0003489402111S1202","doi-asserted-by":"crossref","unstructured":"Hirano M, Hirade Y. 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