Changes in articulatory proficiency following microvascular reconstruction in oral or oropharyngeal cancer.
Articulatory proficiency of /r/ and /s/ sounds, voice quality and resonance, speech intelligibility, and intraoral sensation were examined prospectively before operation, and at four time points during a 1-year follow-up after microvascular transfer. Forty-one patients with a large oral or oropharyngeal carcinoma undergoing tumor resection and free-flap reconstruction usually combined with radiotherapy participated in the study. Articulation, voice, and resonance were investigated both live and from recorded speech samples by two trained linguistic examiners. The patients completed a self-rating of their speech intelligibility and were assessed for anterior intraoral surface sensation by means of 2-point moving discrimination. Misarticulations of /r/ and /s/ increased significantly after the therapy. Voice quality and resonance remained essentially normal. Speech intelligibility deteriorated significantly. Intraoral sensation decreased postoperatively but was not related to speech outcome. Sensate flaps did not prove to be superior in relation to speech tasks. A multidisciplinary approach is advocated in assessment of speech outcome after cancer surgery. Speech therapy is strongly recommended, even in the absence of a gross articulatory handicap.
Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital, Haartmaninkatu 4E, P.O. Box 220, FI-00029 HUS, Helsinki, Finland. mari.markkanen-leppanen@hus.fi
Mari
M
Markkanen-Leppänen
Elina
E
Isotalo
Antti A
AA
Mäkitie
Sirpa
S
Asko-Seljavaara
Timo
T
Pessi
Erkki
E
Suominen
Marja-Leena
ML
Haapanen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001184:Articulation Disorders / Q000209:etiology*; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D020127:Recovery of Function; D013065:Speech Intelligibility; D013524:Surgical Flaps / Q000009:adverse effects