Speech and Swallowing Function After Anterior Tongue and Floor of Mouth Resection With Distal Flap Reconstruction

Abstract

The purpose of this study was to assess the postoperative functioning of oral cancer patients with resections of the anterior tongue and floor of mouth, reconstructed with distal flap closure. Speech and swallowing performance was assessed for 11 men and 5 women preoperatively and at 1 and 3 months postoperatively following a standardized protocol. Speech tasks included an audio recording of a brief conversation and of a standard articulation test; swallowing function was examined using videofluoroscopy. Data were also collected on the number and duration of speech/swallowing treatment sessions, as well as the amount and duration of radiation therapy. Statistical analyses revealed that patients demonstrated a significant and severe impairment in speech and swallow functioning after surgery, with no recovery of function by 3 months post-healing. The degree of impairment in these patients may be related to the adynamic character of the distal flap used for reconstruction. Lack of improvement at the 3-month evaluation may be related to either the timing of postoperative radiation therapy or the low rate (44%) and amount of speech/swallowing treatment provided to these patients.

Tissue/dose compensation to reduce toxicity from combined radiation and chemotherapy for advanced head and neck cancers

“…Speech tasks consisted of an audio recording of a 6 to 7-min conversational speech sample and a reading of the sentence version of the Fisher-Logemann Test of Articulation Competence [11]. Data reduction for swallowing and speech was completed according to methods described by Pauloski et al [12]. Oropharyngeal swallowing efficiency (OPSE), defined as the approximate percentage of the bolus swallowed into the esophagus divided by total transit time, is a global measure that describes the interaction of the speed of movement of the bolus and the safety and efficiency of the mechanism in clearing material from the oropharynx while preventing aspiration [13].…”

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

“…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] .…”

“…Nevertheless, the impairment of post-surgical functions such as articulation, mastication and swallowing has remained as an issue for such patients. Post-surgical dysfunction is strongly dependent on the extent of the surgery and type of reconstruction, and to plan and assess appropriate rehabilitation strategies, data on functional outcomes for specific resections and reconstructions are needed 1 .…”

“…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.…”