title: Obturator prostheses after cancer surgery: an approach to speech outcome assessment.
abstract: OBJECTIVE
  This article describes a speech assessment protocol for patients using either obturator prostheses or speech aid prostheses for surgically acquired defects due to cancer of the maxilla and/or soft palate.
  
  
  METHODS
  This protocol is structured according to the executive summary of "Disability in America: Toward a National Agenda For Prevention" a report formulated by the Institute of Medicine that describes four levels of disorder: (1) pathology, (2) impairment, (3) functional limitation, and (4) disability. Assessment instruments included (1) the Sentence Intelligibility Test to measure the rate and understandability of speech, (2) a speech physiology system to measure appropriate separation of the nasal/nasopharyngeal and oral compartments, (3) a 13-point interval scale to rate speech nasality, and (4) a scale to rate self-perceptions of communication effectiveness.
  
  
  RESULTS
  The results from two patients are reported to illustrate the outcome assessment protocol.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, Omaha, USA.
authors.forename: G K
authors.initials: GK
authors.lastname: Mahanna
authors.forename: D R
authors.initials: DR
authors.lastname: Beukelman
authors.forename: J A
authors.initials: JA
authors.lastname: Marshall
authors.forename: C A
authors.initials: CA
authors.lastname: Gaebler
authors.forename: M
authors.initials: M
authors.lastname: Sullivan
mesh_terms: D004185:Disability Evaluation; D006801:Humans; D008297:Male; D008441:Maxillary Neoplasms / Q000534:rehabilitation*; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects; D017063:Outcome Assessment, Health Care; D010157:Palatal Neoplasms / Q000534:rehabilitation*; D010158:Palatal Obturators; D012123:Pulmonary Ventilation; D013064:Speech Disorders / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation; D013065:Speech Intelligibility; D013068:Speech Production Measurement; D014833:Voice Quality