la’s to investigate how co=laser treatment and radiation treatment of vocal cord cancer T1 differently affects laryngeal vocal function. Methods Twenty-four patients with T1 vocal cord cancer were treated with c02 laser therapy in 9 cases, radiation therapy in 7 cases, and CO=laser and radiation combined in 8 cases. Stroboscopic laryngoscopy, voice acoustic analysis (APQ, PPQ, NN work, NNEa), mean laryngeal expiratory flow rate (plus m) and voice auditory evaluation were performed before and after treatment. Results Combined radiation plus laser treatment had a greater effect on vocal function than laser alone or radiation alone. cQ laser treatment group had a predominantly rough and breath type of voice sound quality change, while radiation treatment group had a predominantly rough, breath and love-open type. Stroboscopic laryngoscopy showed incomplete vocal fold closure, reduced amplitude of vocal fold vibration, and diminished or absent vocal fold mucosal waves in c02 laser-treated patients and some radiation patients. No statistically significant differences in mean laryngeal expiratory flow rate were seen between the c02 laser, radiation, and combined laser plus radiation treatment groups. It was concluded that there was no statistically significant difference in the effect of T1 treatment of vocal cord cancer on laryngeal vocal function with c02 laser versus radiation therapy. Considering the disadvantages of radiation such as long cycle time and many side effects. It is believed that the application of c02 laser therapy to patients with vocal cord cancer Tl will have more superiority. In the past, the treatment of vocal cord cancer Tl was mostly done by radiation therapy or surgery. In recent years, laser technology has been gradually introduced into the treatment of vocal cord cancer, but there are few reports in the literature on the different effects of laser and radiation therapy on laryngeal articulatory function. From 1991 to 1994, 24 cases of T1 patients with vocal cord cancer were treated with radiation therapy, laser therapy and combined radiation plus laser therapy, and voice acoustic analysis, stroboscopic laryngoscopy, laryngeal aerodynamics and subjective auditory evaluation tests were performed before and after treatment. 1. Subjects and methods 1. 1 Subjects 25 patients with vocal cord cancer, 23 males and 1 female, aged 44-88 years old, average 67 years old. Among them, T1.12 patients and T1b12 patients were randomly grouped into radiation therapy group, laser therapy group and combined radiation plus laser therapy group. Seven patients received radiation therapy (total 60 GY), nine patients received C02 laser therapy, and eight patients received combined radiation plus laser therapy, and the combined therapy was followed by laser vaporization of the lesion before radiation therapy. The combined treatment was followed up for more than 3 years after treatment. 1.2 Apparatus and environment: Danish B&K 4914 stroboscope, Japanese Nagashima PS-77H phonophone, Japanese SH-10 (RION) phonophone evaluation device, Elben digital phonophone recorder TEAC A6100. patients were routinely examined by indirect laryngoscope, fiberophone and stroboscope before and after treatment, and detailed records were made. Vocal samples were selected for comfortable vocalization of “e” vowel, with vocal duration of 3. 5 seconds and mouth distance of 20 cnl from the microphone, and the middle smooth voice of the sample was taken for electronic computerized acoustic analysis. mugh, B: bmthy, A: asthenie, s: strained) for auditory evaluation. Recordings, sampling, data analysis and stroboscopic laryngoscopy were performed 3 months after the end of treatment. 1.3 Testing parameters (1) Acoustic analysis parameters of voice: The acoustic analysis method of Ka. suya [1) was used to test the amplitude perturbation quotient (am a curved rodeperturbation quotient, APQ), frequency perturbation quotient (pitchpertllI’bation quotient, PPQ), noise energy level (∞ oralalizednoise energy, NNlEa, NNEb), (2) stroboscopic observation of vocal fold vibration state: symmetry (A n a crutchy, SYM), regularity (. egll] adty, REG), amplitude (AMP), closure state (glottal closure, cLo) of vocal fold vibration SYM is divided into two classes, 0 for asymmetry, I for symmetry, and each of the remaining parameters is divided into three classes, 0 for complete loss of function; 1 for partial loss of function; 2 for normal function. (3) Vocal aerodynamic measurement: mean laryngeal expiratory flow rate (rnem airflow rale, MFR). (4) Voice auditory evaluation parameters measurement: total dumbness score (G), roughness type (R), breath type (B), weakness type (A), tension type (s). Each of these types was subdivided into: normal (o), mild (I), moderate (2), and severe (3). All data in the text were statistically analyzed using electronic computer & .cel statistical software. 2. results The results of acoustic analysis of voice before and after treatment in the radiation treatment group, C02 laser treatment group and combined radiation plus laser treatment group are shown in Table 1, and the results of subjective auditory evaluation, stroboscopic laryngoscopy and mean expiratory flow rate detection are shown in Table 2. from Table 1, it can be seen that the effect of combined radiation plus laser treatment on voice was generally too than that of radiation alone or laser treatment alone, in which the NNEb value of laser treatment before and after the two groups There was a statistically significant difference (P<0.05) between the two groups before and after laser treatment for NNEb values. The values of i.e. q, apq, NNEb, and NNEa in the group treated with laser alone were better than those before treatment. As seen in Table 2, the postoperative values of auditory evaluation and stroboscopic examination were also better than those before treatment. c02 laser treatment group voice sound quality changes were mainly rough and breath type; radiotherapy group was mainly rough, breath type, and tension type; stroboscopic laryngoscopy saw changes such as incomplete vocal hilar closure, reduced amplitude of vocal fold vibration and disappearance of vocal < p=""> mucosal waves in c02 laser treatment and some radiotherapy patients. The mean laryngeal expiratory airflow rate detection was not significantly different between cq laser, radiation therapy and combined laser plus radiation therapy groups. The follow-up of 24 patients revealed 4 cases of tumor recurrence. Two cases belonged to the laser treatment group, one T1a (recurrence after 2 years) and one Tib (recurrence after 1 year), and two cases belonged to the radiation treatment group, both of which were Tlb (one case each after 1 and 2 years). all four cases underwent partial laryngectomy and had no recurrence at 3 years of follow-up. No tumor recurrence was seen in the laser plus radiation therapy group at the 3-year follow-up. Most of the patients’ voices did not affect normal speech communication after radiotherapy, but the current treatment for TI of vocal cord cancer is radiation or surgery, but there are still some shortcomings in radiotherapy, such as the need for a long period (usually 5-8 weeks), the inadvisability of re-radiation therapy after local recurrence, and the tendency to produce comorbidities such as dry throat, chronic pharyngitis, radiological cartilage necrosis, and so on. It has potential carcinogenic effects, etc. Surgical treatment of vocal cord cancer Tl is more damaging to vocal cord tissues, with heavy surgical scar formation and great impact on vocal function. Since Staxmg et al [30 first reported the application of cch laser in the treatment of laryngeal cancer, c02 laser has received increasing attention in the treatment of laryngeal cancer. / / iranol4′ pointed out that there was no significant difference in the cure rate of laser for T1I of vocal cord cancer compared with radiation therapy, and the results of this paper further confirmed this conclusion. From the results, it was seen that the recurrence rate of T1b was greater than that of T1. This may be related to the extent of tumor invasion by the primary site. The tumor recurrence rate in the combined laser and radiation treatment group was significantly smaller than that in the laser alone or radiation alone treatment group. Because of the lack of research reports on whether laser treatment has the same effect on laryngeal vocal function as radiation treatment, this paper evaluates the laryngeal vocal function from four aspects: voice acoustic analysis, stroboscopic laryngoscopy, psychoacoustic evaluation and mean expiratory flow rate. Both the subjective auditory evaluation and the objective quantitative analysis showed that the detected parameters were generally better after treatment than before surgery. Although both laser and radiation therapy can maintain certain speech communication ability, laser has disadvantages compared with radiation therapy, not only does the surgery require general anesthesia, but also the postoperative articulation effect of individual patients is not as good as that of radiation therapy. In summary, from the recurrence rate of tumor and the effect of various treatment methods on pronunciation function, we believe that laser treatment is better for vocal cord cancer T1. and combined laser plus radiation treatment is better for T1b patients, especially those with large tumor protruding from the vocal cord surface. This can avoid damaging the vocal fold tissue too much and maintain good pronunciation after surgery, and also can achieve the purpose of completely curing the tumor. Of course, when deciding which treatment method to use in clinical practice, we should also make specific analysis according to the size, shape and growth area of the tumor as well as the physical and economic conditions of the patient.