Basic and patient-oriented research
Analysis of Determinants on Speech Function After Glossectomy

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Purpose

To determine which of the following factors—type of reconstruction, size of tumor, and site of excision—may influence speech intelligibility after glossectomy.

Materials and Methods

The speech intelligibilities of 27 tongue cancer patients who underwent glossectomy within the range of the hemitongue were investigated within 6 months after operation with a speech intelligibility test formed by 100 sensitive Chinese sounds. They were compared according to the following factors: type of reconstruction (forearm flap or adjacent flap); size of tumor (T1, T2, T3); and site of excision (anterior, middle, posterior, or hemi part).

Results

There was no significant difference in speech intelligibility between the forearm flap reconstructed group and adjacent flap reconstructed group (P > .05). There was a significant difference in the result between the T1 and T3 groups (P < .05). The speech intelligibilities of the patients with tumors in anterior tongue or hemitongue were significantly lower than those with tumor in the middle or posterior tongue (P < .05). Patients with preservation of the tip of the tongue or floor of the mouth had higher intelligibilities (P < .05).

Conclusion

For the patients after glossectomy within the range of hemitongue, except for the type of reconstruction, the tumor site or excision extent of the tongue followed by the tumor size may be key factors in determining the postoperative articulation intelligibility.

Section snippets

Materials and Methods

Between October 2001 and June 2004, 27 patients (14 men, 13 women) with cancer of the tongue were investigated. All subjects were operated on at the Department of Oral and Maxillofacial Surgery of the 9th Affiliated Hospital, Shanghai Jiao Tong University (formerly affiliated with Shanghai Second Medical University), Shanghai, China. Patients ranged in age from 27 to 88 years (mean, 55 years). Within 6 to 37 months of follow-up (mean phase of 15 months), no recurrence occurred in these patients.

Agreement and Reliability of the Examiners

To mark the speech intelligibility, 2 speech pathologists were engaged in this evaluation. To identify the agreement and reliability of their jobs, paired t tests were used in the study. Statistics results showed that there was no significant difference between these 2 examiners in their scoring (P > .05).

Speech Intelligibility of the Patients

The speech intelligibility scores of the 27 patients are listed in Table 3. Compared with the preoperative scores, the postoperative scores of all subjects declined in various degrees because

Discussion

Ablative operation for patients with cancer of the tongue will inevitably contribute to disability of tongue articulatory function. The tongue interacts precisely with nearby structures such as the teeth, alveoli, and palate to perform the motions of articulation.20 While, in the pathologic status following trauma or surgery, the original volume and motion pattern of the tongue will change, contributing to pathologic speech, which severely compromises the patient’s quality of life.

With the

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    Copyright © 2007 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.