Objective approach in the assessment of speech quality in patients with tongue cancer after hemiglossectomy

Abstract

Introduction. Surgery is the leading treatment for tongue cancer, performance which leads to impaired speech function. Because speech is one of the most important tools of social interaction, its disorder can significantly affect patients’ quality of life. To date, there is no generally accepted objective approach to assessing the quality of speech that would make it possible to analyze speech changes at different stages of therapy and help in development of treatment strategy.Aim. To compare the sound reproduction of patients with tongue cancer after hemiglossectomy with and without reconstruction using an objective assessment method, namely – a special software.Materials and methods. The study included 29 patients who received surgical treatment in the volume of hemiglossectomy with ipsilateral cervical lymphodissection. The patients were divided into 2 groups: the group 1 included 14 patients who underwent reconstruction with submental, radial and buccal flaps, the group 2 – 15 patients who did not underwent it. Sound reproduction by each patient was recorded before the operation, no earlier than 10–12 days after it (session of type 1) and after the end of specialized treatment: radiation therapy, chemoradiation therapy (session of type 2). If adjuvant therapy was not prescribed, the type 2 session was performed 3–6 months after surgery. The records made during sessions of the types 1 and 2 were compared with records of preoperative session. During each session, the pronunciation of 30 syllables containing 3 problematic sounds was recorded: [k], [s] and [t] (10 syllables with each of the sounds). The differences in the data obtained during the sessions types 1 and 2 were analyzed according both the syllable set and separately for each sound studied.Results. The reconstruction performed improves sound pronunciation [t] after hemiglossectomy both after surgery and 3–6 months after the end of specialized treatment (p <0.01). After completion of specialized treatment, the pronunciation of the sound [s] significantly improved in both groups. However, in the reconstruction group, the variations in pronunciation values of this sound before the operation and after it obtained in the groups 1 and 2 were significantly reduced. During the assessment of the pronunciation of sound [k], the similar data were obtained. When comparing the quality of speech of patients during the type 2 session, the best results were obtained in group 1: in patients of this group, there were smaller mean differences in the sounds pronunciation as compared to the initial recording (p <0.001) than in patients of group 2.Conclusion. Resection of the tongue most negatively affects pronunciation of the dental-alveolar sounds than the whistling or palatine-dental sounds. The time factor has a positive effect on the speech quality of patients, therefore, the assessment of sound reproduction in patients after hemiglossectomy should be performed no earlier than 3–6 months after the end of specialized treatment.