title: Factors influencing relative speech intelligibility in patients with oral squamous cell carcinoma: a prospective study using automatic, computer-based speech analysis.
abstract: Oral squamous cell carcinoma (OSCC) and its treatment impair speech intelligibility by alteration of the vocal tract. The aim of this study was to identify the factors of oral cancer treatment that influence speech intelligibility by means of an automatic, standardized speech-recognition system. The study group comprised 71 patients (mean age 59.89, range 35-82 years) with OSCC ranging from stage T1 to T4 (TNM staging). Tumours were located on the tongue (n=23), lower alveolar crest (n=27), and floor of the mouth (n=21). Reconstruction was conducted through local tissue plasty or microvascular transplants. Adjuvant radiotherapy was performed in 49 patients. Speech intelligibility was evaluated before, and at 3, 6, and 12 months after tumour resection, and compared to that of a healthy control group (n=40). Postoperatively, significant influences on speech intelligibility were tumour localization (P=0.010) and resection volume (P=0.019). Additionally, adjuvant radiotherapy (P=0.049) influenced intelligibility at 3 months after surgery. At 6 months after surgery, influences were resection volume (P=0.028) and adjuvant radiotherapy (P=0.034). The influence of tumour localization (P=0.001) and adjuvant radiotherapy (P=0.022) persisted after 12 months. Tumour localization, resection volume, and radiotherapy are crucial factors for speech intelligibility. Radiotherapy significantly impaired word recognition rate (WR) values with a progression of the impairment for up to 12 months after surgery.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Erlangen, Germany. Electronic address: Florian.Stelzle@uk-erlangen.de.
authors.forename: F
authors.initials: F
authors.lastname: Stelzle
authors.forename: C
authors.initials: C
authors.lastname: Knipfer
authors.forename: M
authors.initials: M
authors.lastname: Schuster
authors.forename: T
authors.initials: T
authors.lastname: Bocklet
authors.forename: E
authors.initials: E
authors.lastname: Nöth
authors.forename: W
authors.initials: W
authors.lastname: Adler
authors.forename: L
authors.initials: L
authors.lastname: Schempf
authors.forename: P
authors.initials: P
authors.lastname: Vieler
authors.forename: M
authors.initials: M
authors.lastname: Riemann
authors.forename: F W
authors.initials: FW
authors.lastname: Neukam
authors.forename: E
authors.initials: E
authors.lastname: Nkenke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000601:surgery; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000150:complications* / Q000601:surgery; D009367:Neoplasm Staging; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012044:Regression Analysis; D013064:Speech Disorders / Q000209:etiology* / Q000503:physiopathology; D013065:Speech Intelligibility; D049250:Speech Recognition Software
keywords: automatic speech recognition; functional rehabilitation; objective speech assessment; oral carcinoma; outcome analysis; perceptual evaluation; speech intelligibility; squamous cell carcinoma