Speech and Swallow Function After Tonsil/Base of Tongue Resection With Primary Closure

Abstract

Speech and swallowing function was examined in 11 patients who underwent surgical resection of greater than 1 cm of tongue base, tonsil, and faucial arch with mandible resected on the side of the tumor and reconstruction by primary closure. Preoperatively and 1 and 3 months post-healing, high fidelity audio recordings were made of a 6- to 7-minute conversational speech sample, the sentence version of The Fisher Logemann Test of Articulation Competence was administered, and videofluoroscopic assessment of oropharyngeal swallow was conducted. All subjects exhibited changes in speech and swallowing function postoperatively, with little improvement during the study. Patients exhibited greatest difficulty on stop and fricative consonants and bolus propulsion. Comparison with patients who received anterior tongue and floor of mouth resections and distal flap reconstruction revealed consistently better speech performance by the tonsil/base of tongue patients, although the same phonemes were affected. Swallow function was equally affected in the two groups. Results are discussed in terms of locus of surgical resection, nature of reconstruction, and need for swallowing therapy.

Comparison of Psychosocial Outcomes in Head and Neck Cancer Patients Receiving a Coping Strategies Intervention and Control Subjects Receiving No Intervention

“…hoarseness) (List et al, 1999), difficulty breathing (Gotay and Moore, 1992;Rogers et al, 1999) and reduced speech abilities (Epstein et al, 1999;Lazarus et al, 1996;Logemann et al, 1993;Pauloski et al, 1993;Rogers et al, 1999). For example, patients who undergo laryngectomy usually report problemsrelated to speech, altered appearance and decreased perceived abilities when swallowing (de Boer et al, 1995).…”

Recovery from Postsurgical Swallowing Dysfunction in Patients With Oral Cancer

“…Further, liquid OPSE appears to improve more than 12 months post-surgically. These may be explained by the necessity of greater tongue pressure in paste swallowing than with liquids and liquids tend to move more rapidly with gravity alone 3 . It is also possible that the improvement in liquid OPSE is because the pharyngeal motility was well maintained in oral cancer patients, and these patients may be accustomed to the manner or posture for liquid swallowing.…”

“…Swallowing dysfunction after oral and pharyngeal resection with primary closure, distal flap, and vascularized free flap has been discussed [1][2][3][4][5][6][7] . Evaluation of the post-surgical swallowing function was performed mainly with videofluoroscopic measures [1][2][3][4][5][6] , but some authors use subjective methods such as questionnaires or similar with or without videofluoroscopic measurements [7][8][9][10][11][12] .…”

“…Evaluation of the post-surgical swallowing function was performed mainly with videofluoroscopic measures [1][2][3][4][5][6] , but some authors use subjective methods such as questionnaires or similar with or without videofluoroscopic measurements [7][8][9][10][11][12] . Pauloski 4 , Wagner 7 To clarify the course of the recovery of post-surgical swallowing dysfunction between 1 and more than 12 months after surgery, and to determine the correlation among videofluoroscopic measures and medical status indicators, post-surgical oropharyngeal swallow efficiency, nutritional condition, type of nutrition, diet levels, and the occurrence of pneumonia were investigated.…”

A Functional Outcome Swallowing Scale for Staging Oropharyngeal Dysphagia

“…Tube feeding alone is not thought to be a criterion because patients who can swallow limited foods, clude those developed specifically for certain diseases [9,11,13,22,23,25] which are too specific for general yet are tube feeding dependent for the majority of their nutrition, have a distinct psychosocial advantage over use; scales focused on only one component of dysphagia (aspiration [12,19,31], reflux, oral function [8,18,27, patients who can take nothing by mouth. The ability to take small amounts of food by mouth maintains impor-29]), which ignore other components; scales that are dependent on a specific test (barium swallow [11,14,15, tant oral gratification, even if nutrition is maintained by nonoral means. Stages III and IV are thought to be stage II as infrequent (occurs no more than 1-2 times per meal), limited to the subglottis or uppermost trachea important distinct groups in that patients in stage III, although decompensated, are marginally so.…”