title: Speech and voice outcomes in oropharyngeal cancer and evaluation of the University of Washington Quality of Life speech domain.
abstract: BACKGROUND
  Radical treatment of oropharyngeal cancer can have significant impact on speech & voice outcomes.
  
  
  OBJECTIVE
  (i) To assess the extent of speech & voice handicap in disease-free survivors of oropharyngeal squamous cell cancer. (ii) To assess the validity of the speech domain of UWQOL as a screening tool. (iii) To identify clinical characteristics associated with worse speech/voice outcome.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  University Hospital Aintree, a university teaching hospital and tertiary referral centre.
  
  
  METHODS
  All who were treated for oropharyngeal cancer between 1 January 1999 and 31 May 2005, were alive, disease free and willing to participate.
  
  
  METHODS
  Three patient-based questionnaires: University of Washington Quality of Life (UWQOL), voice handicap index (VHI) and voice related quality of life (VRQOL). Three expert-based assessments: GRBAS rating, speech intelligibility and dysarthria rating.
  
  
  RESULTS
  Sixty-six per cent of patients participated. Median VHI score (29) & VRQOL score (15) imply mild to moderate voice impairment. 20% of patients had severe handicap (VHI score >60). Forty-eight per cent had normal voice ratings. Speech was normal in 26%, mildly impaired in 62% and significantly impaired in 12% patients (UWQOL). Correlation between UW-QOL speech domain with speech intelligibility rating was 0.52 (P < 0.001). There were clear demarcations between UW-QOL scores of 30, 70 and 100 on the voice questionnaires. Adverse speech and voice function were associated with tumour stage, radiotherapy (RT) & free-flap surgery.
  
  
  CONCLUSIONS
  Voice & speech impairment is prevalent in >70% of oropharyngeal cancer patients. There is moderate correlation between UWQOL speech domain and speech intelligibility assessment & voice tools making it a quick and easy screening instrument. The main clinical correlates associated with adverse patient and observer rated speech and voice outcomes were tumour stage, RT and free-flap reconstruction.
authors.affiliation: Alderhey Hospital, Liverpool, UK.
authors.forename: L
authors.initials: L
authors.lastname: Thomas
authors.forename: T M
authors.initials: TM
authors.lastname: Jones
authors.forename: S
authors.initials: S
authors.lastname: Tandon
authors.forename: P
authors.initials: P
authors.lastname: Carding
authors.forename: D
authors.initials: D
authors.lastname: Lowe
authors.forename: S
authors.initials: S
authors.lastname: Rogers
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D018572:Disease-Free Survival; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy / Q000601:surgery; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D013064:Speech Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D013065:Speech Intelligibility; D013070:Speech Therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014832:Voice Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D014833:Voice Quality; D014861:Washington