Dysphonia Following Nonsurgical Management of Advanced Laryngeal Carcinoma

Abstract
Traditionally, laryngectomy has been the medical treatment of choice for patients with advanced cancer of the larynx, and voice clinicians have been largely concerned, not with these patients’ dysphonia, but with subsequent alaryngeal voice restoration. Recently, there has been a trend in the management of advanced laryngeal cancer to treat patients with radiation therapy or chemoradiation with the intent of larynx preservation. Although such organ preservation treatment may render the patient free of disease, voice complaints and communicative disabilities frequently continue. These dysphonias represent a new challenge for the voice clinician, who must help the patient cope with what are often highly variable and unpredictable vocal characteristics. This article discusses how advanced glottic cancer and its treatment may contribute to such vocal disturbance, provides some illustrative case examples, and suggests how the clinician can best devise strategies for management.