The Impact of Laser Surgery for Vocal Cord Cysts on Patients' Voice Acoustic Analysis Parameters and Inflammatory Response.

Aim: Vocal cord cyst is a common benign proliferative lesion of the vocal cords, usually resulting from excessive use of the voice, environmental pollution, and inflammatory infections. This study aims to explore the differences in the effectiveness of carbon dioxide (CO₂) laser or surgical treatment for vocal cord cyst patients.

Methods: This retrospective study analyzed 81 patients with vocal cord cysts who underwent surgical treatment at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between July 2021 and July 2024. Among them, 40 patients were treated with CO₂ laser surgery (the laser group), and 41 underwent traditional surgical treatment (the surgery group). The study compared the pre- and post-treatment voice acoustic parameters, aerodynamic parameters, levels of inflammatory factors, stress response indicators, and surgical complications between the two groups.

Results: Before surgery, there were no significant differences between the laser group and the surgery group regarding jitter, shimmer, harmonic-to-noise ratio (HNR), maximum phonation time (MPT), mean airflow rate, and subglottic pressure (p > 0.05). However, at 4 weeks post-surgery, the laser group showed lower values for jitter, shimmer, and mean airflow compared to the surgery group (p < 0.05), while the laser group demonstrated a longer MPT compared to the surgery group (p < 0.05). Before surgery, there were no significant differences between the laser and surgery groups regarding the levels of interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) (p > 0.05). However, at 4 weeks post-surgery, the IL-1β and TNF-α levels in the laser group were lower than those in the surgery group (p < 0.05). Before surgery, there were no significant differences between the laser and surgery groups in Voice Handicap Index (VHI-10) scores and the Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scores (p > 0.05). Moreover, the VHI-10 and GRBAS scores were lower in the laser group compared to the surgery group at 4 weeks post-surgery (p < 0.05). Additionally, the complication rates in the laser group were 12.50%, compared to 24.39% in the surgery group, indicating no significant differences (p > 0.05).

Conclusions: Both CO₂ laser and conventional surgery for treating vocal cord cysts show favorable outcomes. However, CO₂ laser surgery offers faster recovery of vocal function and is more effective at reducing the inflammatory response.