The Impact of a Partial Glossectomy on Articulation and Speech Intelligibility

Abstract

Objectives: The purpose was to determine the changes in intelligibility and articulation after partial glossectomy in a child with Beckwith-Wiedemann syndrome. Methods: For the assessment of articulation, a speech sample was gathered by means of a picture naming test. The analyses included a description of the child’s sound production regardless of their relation to the adult target, as well as analyses comparing the patient’s pronunciations with the adult form. For the assessment of intelligibility the sample was independently rated by 2 experienced speech pathologists using a nominal scale with four categories. Results and Conclusions: Partial glossectomy resulted in a dramatic improvement of speech. Before surgery the speech was definitely not age-appropriate. The child was capable of producing only 23% of the Dutch consonants. This is far less than expected at that age. After surgery, consonant inventory was almost complete and as such was even more than age-appropriate. The partial glossectomy had obviously a positive impact on both place of articulation and manner of articulation. The analyses revealed a tendency towards vowel speech before surgery along with glottal realizations. After surgery the vowel speech and the compensatory articulation patterns had disappeared. Several factors that contributed to the improvement are discussed.

Long-term impact of tongue reduction on speech intelligibility, articulation and oromyofunctional behaviour in a child with Beckwith–Wiedemann syndrome

“…Postoperatively (after central W-shaped tongue reduction) speech was unchanged but the patient was more easily able to elevate the tongue within the oral cavity (coming closer to the target sound). In the case report of Van Lierde et al [16] the phonetic and phonological characteristics of a child with BWS speaking the Dutch language were analysed. Before surgery the speech was definitely not age-appropriate.…”

“…The purposes of this surgical procedure are to improve overall speech intelligibility, articulation, the jaw and tooth growth and cosmetic concerns. The impact of partial glossectomy on overall speech intelligibility or articulation in children with Beckwith-Wiedemann has been studied by several authors [9,[12][13][14][15][16][17][18] (as seen in Table 1) immediately postsurgery.…”

“…These reports mentioned an improvement of intelligibility [12][13][14]16], articulation [16] or phonetic placement of the tongue [15]. Comparison between these reported studies is somewhat difficult because in most studies the specific speech assessment methods or used speech samples (spontaneous speech vs. articulation test vs. intelligbility rating vs. connected speech vs. imitation) were not mentioned and different surgical techniques were performed in children with different ages (between 0.3 and 7 years).…”

“…Moreover detailed analyses comparing phonetic and phonological characteristics in pre-and postoperative conditions in children with BWS are -to the best of our knowledge -very limited. Only in the case reports of Van Lierde et al [16] and Mixter et al [15] detailed sound specific information was provided in the pre-and postsurgical condition. In the case report of Mixter et al [15] the child with BWS Table 1 Literature review regarding speech intelligibility and articulation before and after glossectomy in children with Beckwith-Wiedemann syndrome.…”

Impact of Tongue Reduction on Overall Speech Intelligibility, Articulation and Oromyofunctional Behavior in 4 Children with Beckwith-Wiedemann Syndrome

“…These reports mentioned an improvement of intelligibility [22,24,26] , articulation [26] , or phonetic placement of the tongue, without further detailed specifications. Comparison between these studies is somewhat difficult because the specific speech assessment methods or speech samples were different (spontaneous speech [24] vs. articulation tests [28] ) or are not mentioned, and different surgical techniques (Butlin-Handley technique [22] , circumferential partial glossectomy [23] , wedge-shaped technique [21,24,28] , central W-shaped tongue reduction [25] keyhole procedure [26,27] ) were used in children with different ages (between 0.3 and 7 years). Moreover, detailed analyses comparing overall speech intelligibility, phonetic and phonological characteristics and oromyofunctional behavior in pre-and postoperative conditions in children with BWS are very limited.…”