Современные Аспекты Лечения Больных Со Злокачественными Новообразованиями Орофарингеальной Зоны

Седаков, И. Е.; Семикоз, Н. Г.; Чистяков, А. А.; Степанов, А. И.; Олендарь, Е. М.

doi:10.26435/neoplasm.v10i4.262

Cited by 3 publications

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“…За период с 2010 по 2020 г. на 28,58 % увеличилось количество впервые диагностированных злокачественных заболеваний органов полости рта и ротоглотки [2]. Положение осложняется тем, что 65-70 % больных с данной патологией поступают для специализированного лечения уже с местно-распространенными процессами, в то время, когда им показано комбинированное лечение с обязательным хирургическим компонентом [3,4].…”

Section: Introductionunclassified

“…Основным компонентом комбинированного лечения злокачественных новообразований органов полости рта является хирургическое вмешательство. У больного удаляются объемы тканей данных областей, это вызывает деформирование анатомических структур органов полости рта и существенное нарушение речевой функции [4,5]. После операции у пациентов наблюдается многофакторное изменение речи, которое связанно с нарушением работы мышц, участвующих в артикуляции.…”

Section: Introductionunclassified

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The Role of Computer-Aided Diagnosis in Speech Restoration in Patients with Cancer of the Oral Cavity and Oropharynx after Hemiglosectomy: a Prospective Comparative Study

Krasavina,

Choynzonov,

Kulbakin

et al. 2023

Bulletin of Rehabilitation Medicine

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INTRODUCTION. Oral cavity and oropharyngeal cancers usually require extensive surgeries accompanied by damages to anatomical structures and impaired speech function. AIM. To compare the effectiveness and terms of speech rehabilitation in patients with cancer of the oral cavity and oropharynx using various speech restoration techniques. MATERIALS AND METHODS. We studied the effectiveness and length of speech rehabilitation in 140 patients with stages II–IV oral cavity and oropharyngeal cancer. The age of the patients ranged from 24 to 70 years. All the patients underwent hemiglosectomy. Combined modality treatment and postoperative speech rehabilitation were performed according to the technique developed in the Department of Head and Neck Tumors of the Oncology Research Institute. Speech rehabilitation effectiveness was studied on the basis of subjective and objective evaluation of speech using the computer-software complex (OnkoSpeech v 1.0). RESULTS AND DISCUSSION. Impaired speech function of patients was observed before starting combined modality treatment and manifested as a change in the prosodic system of speech and subjective communication difficulties associated with the presence of a tumor. After surgery, all the patients demonstrated impaired speech function, ranging from distorted pronunciation to the complete absence of verbal communication. Speech rehabilitation started 8 to 29 days after surgery: in the study group I, Me = 9.6, in the study group II, Me = 9.8, values did not have statistically significant differences (p 0.05). At the beginning of speech rehabilitation, to restore activity and coordinate the work of articulatory apparatus muscles and speech expiration, special complexes of articulation and breathing exercises followed by sound pronunciation correction were performed. Postoperative speech rehabilitation resulted in the improvement of speech function in 100 % of cases. In group II, where the correction of sound pronunciation was performed on the basis of speech diagnosis data using the OnkoSpeech v 1.0 computer-software complex, it was possible to achieve a better result of sound pronunciation correction of all the studied sounds, except for hissing (lingual-frontal) [sh], [zh], [shch], [ch]. CONCLUSION. The use of the OnkoSpeech v1. ± software package for speech computer-aided diagnosis made it possible to objectively evaluate and quantify the effectiveness of the correction of the sound pronunciation of six phonemes of the Russian language, improve the results of the correction of sound pronunciation and reduce the time of speech therapy.

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Section: Introductionunclassified

The Role of Computer-Aided Diagnosis in Speech Restoration in Patients with Cancer of the Oral Cavity and Oropharynx after Hemiglosectomy: a Prospective Comparative Study

Krasavina,

Choynzonov,

Kulbakin

et al. 2023

Bulletin of Rehabilitation Medicine

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“…В России с 2008 по 2018 г. отмечалось увеличение заболеваемости раком полости рта и ротоглотки [3] устойчивый характер и поддаются лишь частичной коррекции [2,[4][5][6]. Нарушение речевой функции для большинства больных является тяжелой психологической травмой, которая ставит их перед необходимостью менять привычный образ жизни, порой профессию.…”

Section: Introductionunclassified

Speech Rehabilitation of Patients With Oral Cavity and Oropharyngeal Cancers After Reconstructive Surgery

et al. 2020

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Oral cavity and oropharyngeal cancers usually require extensive surgeries accompanied by damages to anatomical structures and impaired speech function. The use of reconstructive-plastic techniques to replace defects after surgical resection allows the creation of a favorable functional basis for speech restoration.The purpose of the study was to compare the effectiveness and terms of speech restoration in patients with oral cavity and oropharyngeal cancers after surgical treatment using various reconstructive surgery techniques to restore postoperative defects.Material and Methods. Speech rehabilitation results were analyzed in 56 patients with stage II–IV oral cavity and oropharyngeal cancers. The age of the patients ranged from 26 to 70 years. The patients underwent either hemiglossectomy or glossectomy followed by reconstructive surgery. Postoperative speech rehabilitation was performed according to the technique developed in the Department of Head and Neck Tumors of the Cancer Research Institute. Speech function was assessed before starting treatment, at the beginning of treatment and after completion of speech rehabilitation.Results. After surgery, all patients demonstrated impaired speech function, ranging from distorted pronunciation to the complete absence of verbal communication for 5 (71.4%) and 4 (80%) patients from Ib and IIb respectively. Speech rehabilitation started 16 to 32 days after surgery. Restoration of the activity and coordination of the articulatory apparatus muscles, speech exhalation and reconstructed tongue was followed by a sound pronunciation. Postoperative speech rehabilitation allowed improvement of speech function in 100 % of cases (56 patients). A complete speech restoration was achieved for 7 patients (12.5%). The majority of these patients were from the group with hemiglossectomy. In the group of patients with glossectomy, the amplitude and coordination of movements, which could be achieved by performing articulation exercises for the reconstructed tongue, depended on the size of the remaining part of their own tissues.Conclusion. Good values of all studied parameters were observed in patients, who underwent hemiglossectomy followed by reconstruction with a free revascularized flap. No statistically significant differences between the studied parameters were found in patients, who underwent glossectomy. Speech restoration parameters were significantly better in the group of patients with hemiglossectomy and reconstruction with a free revascularized flap than in the group of patients with glossectomy).

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Correction of eating disorders in patients with oral and oropharyngeal cancer after reconstructive plastic surgery

Красавина

Choynzonov

Kulbakin

et al. 2021

Opuholi golovy i šei

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The study objective – to evaluate the feasibility of correcting eating disorders in patients undergoing surgery for oral and oropharyngeal cancers using various reconstructive techniques to restore postoperative defects.Materials and methods. Between 2012 and 2019, a total of 56 patients with stage II–IV oral and oropharyngeal cancer underwent reconstructive surgery after either hemiglossectomy or glossectomy. The patients ranged in age from 26 to 70 years. The patients were divided into two groups. Group I consisted of 36 (64.3 %) patients who underwent tongue reconstruction using rotation flaps. For reconstruction of hemiglossectomy defects, a chin flap was used, and for reconstruction of glossectomy defects, a pectoral flap was used. Group II comprised 20 (35.7 %) patients who underwent tongue reconstruction using free revascularized flaps. For the tongue reconstruction after hemiglossectomy, the radial flap, medial sural perforator flap and fasciocutaneous anterolateral thigh flap were used. For the tongue reconstruction after glossectomy, the fasciocutaneous anterolateral thigh flap was used. The acts of chewing and swallowing were restored during speech rehabilitation due to the activation and coordination of the work of the muscles of the cheeks, lips, soft palate, pharynx, and the reconstructed tongue. Eating disorders were assessed by interviewing patients. A comparative analysis of eating disorders included mobility and coordination of facial muscles and reconstructed tongue, increased sensitive in the oral cavity, the presence of aspiration and nasal regurgitation, and subjective difficulties of patients. The time before the start of rehabilitation and its duration were taken into account. Patients were interviewed before the start of the combined treatment, at the beginning and after the completion of rehabilitation.Results. After the completion of rehabilitation, all patients received food by the oral route. The best outcomes were achieved in group 2a patients, who underwent tongue reconstruction with free revascularized flaps. This group of patients had a lower percentage of the asymmetry of facial muscles and limited mobility of the tongue compared to other groups of patients.In the subgroups of patients undergoing glosssectomy, most of the studied parameters did not have statistically significant differences in values. However, it should be noted that in group 2b, the period from the date of surgical treatment to the beginning of rehabilitation was significantly longer than in group 1b.Conclusion. The use of the microvascular surgical techniques using various donor flaps creates the basis for a more complete functional recovery and expands the rehabilitation potential of patients after surgical treatment of oral and oropharyngeal cancer.

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Современные Аспекты Лечения Больных Со Злокачественными Новообразованиями Орофарингеальной Зоны

Cited by 3 publications

References 0 publications

The Role of Computer-Aided Diagnosis in Speech Restoration in Patients with Cancer of the Oral Cavity and Oropharynx after Hemiglosectomy: a Prospective Comparative Study

The Role of Computer-Aided Diagnosis in Speech Restoration in Patients with Cancer of the Oral Cavity and Oropharynx after Hemiglosectomy: a Prospective Comparative Study

Speech Rehabilitation of Patients With Oral Cavity and Oropharyngeal Cancers After Reconstructive Surgery

Correction of eating disorders in patients with oral and oropharyngeal cancer after reconstructive plastic surgery

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