title: Self-perception versus professional assessment of functional outcome after ablative surgery in patients with oral cancer.
abstract: OBJECTIVE
  The extent of functional impairment after ablative surgery in the orofacial region may be directly reflected in a reduction in Quality of Life. This study intended to compare the patients' perception with an objective functional evaluation of the orofacial system in order to bilaterally distinguish direct influence factors.
  
  
  METHODS
  A total of 45 patients were included in this study and were asked to complete the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-30) and the Head and Neck 35 Module (H&N 35). Afterward one independent speech therapist evaluated the patients applying the Frenchay Dysarthria Assessment regarding four main categories: mouth opening, tongue motility, swallowing and intelligibility. Comparisons between groups were performed using Whitney-Mann U-Wilcoxon test and calculating Spearman's rho.
  
  
  RESULTS
  Overall the professional assessments by the speech therapists revealed significantly higher scores regarding intelligibility, swallowing and mouth opening when compared to the patients' self-perception. Smaller tumor sizes, no bone resection and local reconstruction techniques led to significantly better functional outcomes, when assessed by speech therapists. Swallowing was perceived significantly better by patients in cases of local reconstruction.
  
  
  CONCLUSIONS
  From the professionals' point of view differences were perceived in more items compared to the patients' self-assessments, who widely experienced a more severe functional impairment. Physicians should take this into account when discussing adverse therapy effects with the patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Campus Forschung Gebäude N27, 20246, Hamburg, Germany. b.beck-broichsitter@uke.de.
authors.forename: Benedicta E
authors.identifier: http://orcid.org/0000-0003-4664-5966
authors.initials: BE
authors.lastname: Beck-Broichsitter
authors.affiliation: Department of Oral and Maxillofacial Surgery, Schleswig-Holstein University Hospital, Arnold-Heller-Straße 3, Haus 26, 24105, Kiel, Germany.
authors.forename: Jörn
authors.initials: J
authors.lastname: Huck
authors.affiliation: Reference Center on Quality of Life in Oncology, Schleswig-Holstein University Hospital, Arnold-Heller-Straße 3, Haus 18, 24105, Kiel, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Küchler
authors.affiliation: Kaufbeuren Hospital, Kemnater Str. 16, 87600, Kaufbeuren, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Hauke
authors.affiliation: Institute of Medical Informatics and Statistics, Schleswig-Holstein University Hospital, Brunswiker Straße 10, 24105, Kiel, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hedderich
authors.affiliation: Department of Oral and Maxillofacial Surgery, Schleswig-Holstein University Hospital, Arnold-Heller-Straße 3, Haus 26, 24105, Kiel, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Wiltfang
authors.affiliation: Department of Oral and Maxillofacial Surgery, Schleswig-Holstein University Hospital, Arnold-Heller-Straße 3, Haus 26, 24105, Kiel, Germany.
authors.forename: Stephan T
authors.initials: ST
authors.lastname: Becker
mesh_terms: D000328:Adult; D000368:Aged; D003679:Deglutition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000503:physiopathology / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care; D017060:Patient Satisfaction; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D012649:Self Concept; D013065:Speech Intelligibility; D016896:Treatment Outcome
keywords: Functional outcome; Objective assessment; Oral cancer; Quality of Life; Self-perception