engleski

Early Diagnosis of Laryngeal Cancer

Hoarseness is a noticeable symptom, which can be a consequence of the laryngeal tumor and vocal folds, in particular. Therefore, examination of larynx is an imperative for every change of the usual vocal characteristics. As a symptom, hoarseness frequently oscillates in chronic laryngeal states (morphologic or functional, such as: oedema, inflammation, degeneration, myopathy, hyperkinesis) and is not always a warning sign of the appearance of a malign tumor. This implies the necessity of regular examinations by laryngologist and phoniatrician. Those can often include examination of the vocal fold vibration process by the techniques of stroboscopy and slow motion analysis, in order to detect deviations that are possible signal of tumor infiltration. Vecerina published her observations in 1980, about frequent changes of fundamental tone at early malign alteration of the vocal fold epithelium. She assumed this acoustic parameter could be valuable diagnostic sign for biopsy indication. Recent investigation and development of acoustic computer analyses included "jitter" analysis on a group of patients with early vocal fold carcinoma and other laryngeal pathology. The value of jitter was found as a significant acoustic sign in rising a suspicion of early malignancy. Furthermore, the screening possibility of risky examinees by tele-analysis of acoustic signal was inaugurated. Stroboscopy (analysis of vibration and glottic wave) and examination of provoked Bernoulli phenomenon were performed on all examinees who revealed increased jitter. Correlation was found between increased jitter and following parameters: irregular vibrations, disturbed glottic wave and reduced Bernoulli phenomenon. Significant number of patients with increased jitter and deviation of previously mentioned vibratory and tissue-elastic parameters from standard values were diagnosed in vocal fold carcinoma in very early stage. The technology that enables relevant vibratory and acoustic analysis of vocal folds and voice, makes possible to diagnose vocal fold carcinoma in the phase of its localization in Reinke's space ; that is, in very early phase. Possibility of acoustic screening of risky patients is being assumed, which should be followed by laryngologic examination and vibratory analysis. This could significantly contribute to the early diagnosis of laryngeal carcinoma, particularly in smokers, as highly risky population.

hoarseness; vocal fold carcinoma; jitter; stroboscopy

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