title: Tongue strength as a predictor of functional outcomes and quality of life after tongue cancer surgery.
abstract: OBJECTIVE
  Surgical resection of oral cancer can result in altered speech, swallowing, and quality of life (QOL). To date, the oral outcome variables of tongue strength, tongue and jaw range of motion, and saliva production have not been extensively assessed. This pilot study was done to assess tongue strength along with other oral outcomes and their relationship to performance status for speech, swallowing, and QOL after partial glossectomy. Our aim was to create a norm for what should be considered a normal tongue strength value in this population. We hypothesized that patients with tongue strength of 30 kPa or greater would perform better on the performance status scale and various QOL measures than do patients with tongue strength of less than 30 kPa.
  
  
  METHODS
  We used a cross-sectional design in this study. The postoperative assessment included 1) Performance Status Scale and Karnofsky Performance Status Scale; 2) oral outcome variables of tongue strength, jaw range of motion. and saliva production; and 3) patient-rated QOL ratings via Eating Assessment Tool, M. D. Anderson Dysphagia Inventory, EORTC-H&N35, and Speech Handicap Index.
  
  
  RESULTS
  Patients with tongue strength of at least 30 kPa performed better on the performance status scales and various QOL measures. The cutoff score of 30 kPa for tongue strength measures revealed a trend in predicting performance on the scales and QOL measures.
  
  
  CONCLUSIONS
  The oral outcome variables correlated with performance status for speech, swallowing, and QOL. We propose a norm for tongue strength in this population, based on the trend seen in this group of patients, as none previously existed. Future studies are under way that incorporate a larger sample size to further validate this norm. Future studies will also examine oral functional outcome measures in a larger population by inclu'ding other oral and oropharyngeal sites to help predict speech and swallow performance status and QOL.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Beth Israel Medical Center, New York, New York, USA.
authors.forename: Cathy L
authors.initials: CL
authors.lastname: Lazarus
authors.forename: Hasan
authors.initials: H
authors.lastname: Husaini
authors.forename: Sumeet M
authors.initials: SM
authors.lastname: Anand
authors.forename: Adam S
authors.initials: AS
authors.lastname: Jacobson
authors.forename: Jackie K
authors.initials: JK
authors.lastname: Mojica
authors.forename: Daniel
authors.initials: D
authors.lastname: Buchbinder
authors.forename: Mark L
authors.initials: ML
authors.lastname: Urken
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003679:Deglutition / Q000502:physiology*; D005260:Female; D006801:Humans; D007568:Jaw / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D011788:Quality of Life; D016059:Range of Motion, Articular; D020127:Recovery of Function / Q000502:physiology*; D013060:Speech; D014059:Tongue / Q000503:physiopathology* / Q000601:surgery; D014062:Tongue Neoplasms / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome