Digitised evaluation of speech intelligibility using vowels in maxillectomy patients

Abstract

Among the functional disabilities that patients face following maxillectomy, speech impairment is a major factor influencing quality of life. Proper rehabilitation of speech, which may include prosthodontic and surgical treatments and speech therapy, requires accurate evaluation of speech intelligibility (SI). A simple, less time-consuming yet accurate evaluation is desirable both for maxillectomy patients and the various clinicians providing maxillofacial treatment. This study sought to determine the utility of digital acoustic analysis of vowels for the prediction of SI in maxillectomy patients, based on a comprehensive understanding of speech production in the vocal tract of maxillectomy patients and its perception. Speech samples were collected from 33 male maxillectomy patients (mean age 57.4 years) in two conditions, without and with a maxillofacial prosthesis, and formant data for the vowels /a/,/e/,/i/,/o/, and /u/ were calculated based on linear predictive coding. The frequency range of formant 2 (F2) was determined by differences between the minimum and maximum frequency. An SI test was also conducted to reveal the relationship between SI score and F2 range. Statistical analyses were applied. F2 range and SI score were significantly different between the two conditions without and with a prosthesis (both P < .0001). F2 range was significantly correlated with SI score in both the conditions (Spearman's r = .843, P < .0001; r = .832, P < .0001, respectively). These findings indicate that calculating the F2 range from 5 vowels has clinical utility for the prediction of SI after maxillectomy.

A nonconventional approach to prevent mouth dryness in a patient with a complex maxillofacial defect

“…The F2 range of the patient was significantly larger when the face cover was used and the value was comparable to our previous study. 14 Acoustic evaluation indicated that the patient had good speech performance, and air leakage through the nasal cavity and orbit to the oral cavity was decreased when she was using the facial cover compared with gauze. This is because the gauze did not completely cover the defect, and because air was able to pass through the mesh surface of the gauze.…”

Nutritional assessment in a maxillectomy patient from the preoperative period to definitive obturator insertion: A case report

“…It is possible to provide an immediate surgical obturator in collaboration not only with oral, head and neck, and plastic surgeons in the same hospital, but also with other hospitals [10]. A notable and useful point is to provide an immediate surgical obturator, reduce contamination of the surgical wound, and enable relatively normal speech [11] and swallowing [12] in the immediate postoperative period. It is also advantageous because wearing an immediate surgical obturator shortens the period of tube feeding and enables early initiation of oral nutrition [13].…”

Two-step fabrication of an obturator prosthesis for a large maxillary defect with digital speech analysis: A case report

“…In patients with maxillary defects, the oral defect is often connected to the nasal cavity 1 which impairs functional ability especially speech. [2][3][4] Maxillofacial prostheses play an important role in the rehabilitation of these patients. 5 However, the fabrication and adjustment of the prosthesis is complicated because of the varied anatomy of the defect and the unique function of the orofacial region.…”