Speech intelligibility after glossectomy and speech rehabilitation.
BACKGROUND
Oral tumor resections cause articulation deficiencies, depending on the site, extent of resection, type of reconstruction, and tongue stump mobility.


OBJECTIVE
To evaluate the speech intelligibility of patients undergoing total, subtotal, or partial glossectomy, before and after speech therapy.


METHODS
Twenty-seven patients (24 men and 3 women), aged 34 to 77 years (mean age, 56.5 years), underwent glossectomy. Tumor stages were T1 in 3 patients, T2 in 4, T3 in 8, T4 in 11, and TX in 1; node stages, N0 in 15 patients, N1 in 5, N2a-c in 6, and N3 in 1. No patient had metastases (M0). Patients were divided into 3 groups by extent of tongue resection, ie, total (group 1; n = 6), subtotal (group 2; n = 9), and partial (group 3; n = 12). Different phonological tasks were recorded and analyzed by 3 experienced judges, including sustained 7 oral vowels, vowel in a syllable, and the sequence vowel-consonant-vowel (VCV). The intelligibility of spontaneous speech (sequence story) was scored from 1 to 4 in consensus. All patients underwent a therapeutic program to activate articulatory adaptations, compensations, and maximization of the remaining structures for 3 to 6 months. The tasks were recorded after speech therapy. To compare mean changes, analyses of variance and Wilcoxon tests were used.


RESULTS
Patients of groups 1 and 2 significantly improved their speech intelligibility (P<.05). Group 1 improved vowels, VCV, and spontaneous speech; group 2, syllable, VCV, and spontaneous speech. Group 3 demonstrated better intelligibility in the pretherapy phase, but the improvement after therapy was not significant.


CONCLUSIONS
Speech therapy was effective in improving speech intelligibility of patients undergoing glossectomy, even after major resection. Different pretherapy ability between groups was seen, with improvement of speech intelligibility in groups 1 and 2. The improvement of speech intelligibility in group 3 was not statistically significant, possibly because of the small and heterogeneous sample.
Furia
C L
CL
Department of Voice, Speech and Swallowing Rehabilitation, Centro de Tratamento e Pesquisa Hospital do Câncer A. C. Camargo, Rua Professor Antônio Prudente, 211 Liberdade, 01509-010 São Paulo, Brazil.
Kowalski
L P
LP
Latorre
M R
MR
Angelis
E C
EC
Martins
N M
NM
Barros
A P
AP
Ribeiro
K C
KC
D000328:Adult; D000368:Aged; D001184:Articulation Disorders / Q000534:rehabilitation*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005927:Glossectomy / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010700:Phonetics; D011183:Postoperative Complications / Q000534:rehabilitation*; D013065:Speech Intelligibility; D013068:Speech Production Measurement; D013070:Speech Therapy; D014062:Tongue Neoplasms / Q000473:pathology / Q000601:surgery*