Objective Assessment of Speech after Surgical Treatment for Oral Cancer: Experience from 196 Selected Cases

In 1992, a personal computer–based workstation for speech-digitized analysis was developed in conjunction with Canniesburn Hospital and Edinburgh University to measure all dispersion in speech after surgery for oral cancer. The voices of 196 patients with tumor of the oral cavity were recorded preoperatively and postoperatively. Surgical resection was carefully mapped out on standard diagrams of the oral cavity. Patients’ recordings were assessed for conversational understandability by two referees. Patients also self-scored their speech using the Functional Intraoral Glasgow Scale self-questionnaire. Many patients had similar if not identical resections; therefore, 12 homogeneous groups were identified. Functional outcome for speech was correlated with the site and size of resected tissue and with the reconstruction modalities. The original association of an objective, computer-based tool and two subjective assessment tools proved to be the most suitable investigation method for speech. The general pattern was for consistently better speech quality with smaller excisions. The reconstruction modalities did not seem to influence the overall speech quality, as it was related mainly to the extent of surgical demolition. The authors present a detailed correlation between site and size of excision and functional outcome using color multiple-view diagrams for immediate appreciation. Positive and negative prognostic factors were identified in surgery for oral cancer.

[1]  R Schönweiler,et al.  Speech, deglutition and life quality after intraoral tumour resection. A prospective study. , 1998, International journal of oral and maxillofacial surgery.

[2]  John Laver,et al.  Objective speech quality assessment in patients with intra-oral cancers: voiceless fricatives , 1992, ICSLP.

[3]  Alan Wrench,et al.  Evaluation of a system for segmental speech quality assessment: voiceless fricatives , 1995, EUROSPEECH.

[4]  J. Sciubba,et al.  Speech patterns following partial glossectomy for small tumors of the tongue , 1991, Head & neck.

[5]  A. Wrench,et al.  Carcinoma of the tongue: the speech therapist's perspective. , 1999, The British journal of oral & maxillofacial surgery.

[6]  J. Logemann,et al.  Surgical Variables Affecting Speech in Treated Patients With Oral and Oropharyngeal Cancer , 1998, The Laryngoscope.

[7]  D. Soutar,et al.  The radial forearm flap: A versatile method for intra‐oral reconstruction , 1984 .

[8]  D. Shedd,et al.  Disability and rehabilitation in head and neck cancer patients after treatment. , 1978, Head & neck surgery.

[9]  D. Soutar,et al.  The Radial Forearm Flap in Intraoral Reconstruction: The Experience of 60 Consecutive Cases , 1986, Plastic and reconstructive surgery.

[10]  J. Fernández Feijoo,et al.  Functional consequences of partial glossectomy. , 1994, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[11]  Mark Von Tress.  Statistical Models for Ordinal Variables , 1995 .

[12]  C. Espie,et al.  Functional implications of major surgery for intraoral cancer. , 1989, British journal of plastic surgery.

[13]  D. Soutar,et al.  An evaluation of functional outcome after surgery and radiotherapy for intraoral cancer. , 1992, The British journal of oral & maxillofacial surgery.

[14]  A. Rademaker,et al.  T stage and functional outcome in oral and oropharyngeal cancer patients , 1996, Head & neck.

[15]  James S. Brown,et al.  The University of Washington head and neck cancer measure as a predictor of outcome following primary surgery for oral cancer , 1999, Head & neck.

[16]  J. Teichgraeber,et al.  New test series for the functional evaluation of oral cavity cancer. , 1985, Head & neck surgery.

[17]  L. Scheker,et al.  The radial forearm flap: a versatile method for intra-oral reconstruction. , 1983, British journal of plastic surgery.