title: Evaluation of speech outcomes using English version of the Speech Handicap Index in a cohort of head and neck cancer patients.
abstract: The aim of this study was to explore post-treatment speech impairments using English version of Speech Handicap Index (SHI) (first speech-specific questionnaire) in a cohort of oral cavity (OC) and oropharyngeal (OP) cancer patients. Sixty-three consecutive OC and OP cancer patients in follow-up participated in this study. Descriptive analyses have been presented as percentages, while Mann-Whitney U-test and Kruskall-Wallis test have been used for the quantitative variables. Statistical Package for Social Science-15 statistical software (SPSS Inc., Chicago, IL) was used for the statistical analyses. Over a third (36.1%) of patients reported their speech as either average or bad. Speech intelligibility and articulation were the main speech concerns for 58.8% and 52.9% OC and 31.6% and 34.2% OP cancer patients, respectively. While feeling of incompetent and being less outgoing were the speech-related psychosocial concerns for 64.7% and 23.5% OC and 15.8% and 18.4% OP cancer patients, respectively. Worse speech outcomes were noted for oral tongue and base of tongue cancers vs. tonsillar cancers, mean (SD) values were 56.7 (31.3) and 52.0 (38.4) vs. 10.9 (14.8) (P<0.001) and late vs. early T stage cancers 65.0 (29.9) vs. 29.3 (32.7) (P<0.005). The English version of the SHI is a reliable, valid and useful tool for the evaluation of speech in HNC patients. Over one-third of OC and OP cancer patients reported speech problems in their day-do-day life. Advanced T-stage tumors affecting the oral tongue or base of tongue are particularly associated with poor speech outcomes.
authors.affiliation: Head and Neck Unit, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK. raghav_dwivedi@rediffmail.com
authors.forename: Raghav C
authors.initials: RC
authors.lastname: Dwivedi
authors.forename: Suzanne
authors.initials: S
authors.lastname: St Rose
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Chisholm
authors.forename: Brian
authors.initials: B
authors.lastname: Bisase
authors.forename: Furrat
authors.initials: F
authors.lastname: Amen
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Nutting
authors.forename: Peter M
authors.initials: PM
authors.lastname: Clarke
authors.forename: Cyrus J
authors.initials: CJ
authors.lastname: Kerawala
authors.forename: Peter H
authors.initials: PH
authors.lastname: Rhys-Evans
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Harrington
authors.forename: Rehan
authors.initials: R
authors.lastname: Kazi
mesh_terms: D001184:Articulation Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000150:complications* / Q000628:therapy; D009959:Oropharyngeal Neoplasms / Q000150:complications* / Q000628:therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013064:Speech Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D013065:Speech Intelligibility; D011795:Surveys and Questionnaires; D014062:Tongue Neoplasms / Q000150:complications / Q000628:therapy; D014067:Tonsillar Neoplasms / Q000150:complications / Q000628:therapy; D016896:Treatment Outcome