title: Swallowing, speech and quality of life in patients undergoing resection of soft palate.
abstract: The aim of this study was to evaluate swallowing, speech and quality of life in patients undergoing surgery for malignant tumors involving soft palate. We performed a cross sectional study of 23 patients (aged 32-80 years), submitted to soft palate resection, free of disease for at least 1 year. Primary closure of the surgical defect was performed in 5 patients (21.7 %), adaptation of a palatal obturator prosthesis in 2 (8.7 %), myocutaneous flap in 5 (21.7 %), local flap in 2 (8.7 %) and microsurgical free flap in 9 (39.1 %). All patients were submitted to fibreoptic endoscopic evaluation and completed functional and quality of life questionnaires. Functional evaluation of swallowing showed higher prevalence of pooling of food in the nasopharynx in patients submitted to regional flap reconstruction or primary closure (53.9 %). Swallowing difficulties were predominantly related to solid foods (54.5 %) and were associated with more extensive palatal resections. Most individuals submitted to reconstruction with microsurgical flaps had satisfactory velopharyngeal mobility (87 %). The presence of nasal air escape or velopharyngeal gap was minimal in most of the sample. Hypernasality contributed minimally to imprecisions in speech articulation or intelligibility. Vocal alteration did not impact patients' quality of life. Pharyngeal phase of swallowing was satisfactory in most patients. However, nasal reflux and penetration were present in a few patients. Most patients had minimal phono-articulatory alterations as a global outcome. Scores of swallowing and speech parameters regarding the questionnaires used were high, demonstrating minor impact on quality of life.
authors.affiliation: Department of Speech Therapy, Hospital A. C. Camargo, São Paulo, Brazil.
authors.forename: Lívia Fernandes
authors.initials: LF
authors.lastname: Barata
authors.forename: Genival Barbosa
authors.initials: GB
authors.lastname: de Carvalho
authors.forename: Elisabete
authors.initials: E
authors.lastname: Carrara-de Angelis
authors.forename: José Carlos Marques
authors.initials: JC
authors.lastname: de Faria
authors.forename: Luiz Paulo
authors.initials: LP
authors.lastname: Kowalski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010157:Palatal Neoplasms / Q000473:pathology / Q000601:surgery*; D010160:Palate, Soft / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D013064:Speech Disorders / Q000453:epidemiology*; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D016896:Treatment Outcome