Voice Quality and Laryngeal Findings in Patients With Suspected Lung Cancer

Davis, Ruth J. MD
Messing, Barbara PhD
Cohen, Neri M. MD, PhD
Akst, Lee M. MD

¹Department of Otolaryngology–Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
²The Milton J. Dance Jr Head and Neck Center, Johns Hopkins Voice Center at GBMC Healthcare, Baltimore, Maryland, USA
³Division of Thoracic Surgery, Department of Surgery, GBMC Healthcare, Baltimore, Maryland, USA

Ruth J. Davis, MD, Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA. Email: [email protected]

Received December 30, 2020

Accepted March 18, 2021

Otolaryngology - Head & Neck Surgery 166(1):p 133-138, January 2022. | DOI: 10.1177/01945998211008382

Objective

To describe laryngeal findings and voice quality in patients with suspected lung cancer, relative to voice quality and possible laryngeal pathology.

Study Design

Prospective cohort study.

Setting

Tertiary care center.

Methods

Patients with known or suspected lung cancer were approached before planned thoracic surgery, and they completed acoustic analysis, the Voice-Related Quality of Life (V-RQOL) questionnaire, and stroboscopy. The prevalence of dysphonia, V-RQOL and Cepstral Spectral Index of Dysphonia (CSID) scores, and laryngeal findings were examined and compared between patients ultimately found to have lung cancer and those without cancer.

Results

Sixty-one patients (45 cancer, 16 noncancer) were analyzed. Patients with cancer were older than those without (mean ± SD, 72.3 ± 9.94 vs 62.6 ± 9.30 years; P = .001). Otherwise, the distribution of stroboscopy findings, acoustic measures, and self-reported voice handicap were similar between the cancer and noncancer cohorts. Prior to surgery, no patients had vocal cord paralysis or obvious neoplasm, though 4 (6.56%) had leukoplakia and 28 (45.9%) had vocal fold movement asymmetry on stroboscopy. Overall, 21 patients (35.0%) had average CSID scores >19, and 13 (21.7%) had CSID scores >24; however, only 4 self-described their voice as not working as it should, and only 2 had a V-RQOL score <85.

Conclusion

Patients with suspected lung cancer have moderate dysphonia on acoustic measures, though self-reported impact on quality of life is low. While leukoplakia was seen in 4 patients, obvious neoplasm and occult paralysis were not seen in this cohort. Together, these findings suggest that patients with suspected lung cancer should be assessed for subjective voice dysfunction, but routine laryngeal screening may otherwise be unnecessary.