Long-term functional outcomes and quality of life after partial glossectomy for T2 squamous cell carcinomas

Riva, Giuseppe; Sapino, Silvia; Ravera, Mattia; Elia, Giulia; Pecorari, Giancarlo

doi:10.1016/j.bjorl.2021.06.009

Cited by 9 publications

(15 citation statements)

References 24 publications

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“…However, speech is one of the most distressing problems for patients [ 6 – 8 ]. In previous studies, researchers confirmed that chemoradiotherapy and surgery affected patients’ speech intelligibility [ 9 – 11 ]. The tongue plays a significant role in speech due to its flexible mobility and strong muscles.…”

Section: Introductionmentioning

confidence: 79%

Speech disorders in patients with Tongue squamous cell carcinoma: A longitudinal observational study based on a questionnaire and acoustic analysis

et al. 2023

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Background Speech disorders are common dysfunctions in patients with tongue squamous cell carcinoma (TSCC) that can diminish their quality of life. There are few studies with multidimensional and longitudinal assessments of speech function in TSCC patients. Methods This longitudinal observational study was conducted at the Hospital of Stomatology, Sun Yat-sen University, China, from January 2018 to March 2021. A cohort of 92 patients (53 males, age range: 24–77 years) diagnosed with TSCC participated in this study. Speech function was assessed from preoperatively to one year postoperatively using the Speech Handicap Index questionnaire and acoustic parameters. The risk factors for postoperative speech disorder were analyzed by a linear mixed-effects model. A t test or Mann‒Whitney U test was applied to analyze the differences in acoustic parameters under the influence of risk factors to determine the pathophysiological mechanisms of speech disorders in patients with TSCC. Results The incidence of preoperative speech disorders was 58.7%, which increased up to 91.4% after surgery. Higher T stage (P＜0.001) and larger range of tongue resection (P = 0.002) were risk factors for postoperative speech disorders. Among the acoustic parameters, F2/i/decreased remarkably with higher T stage (P = 0.021) and larger range of tongue resection (P = 0.009), indicating restricted tongue movement in the anterior-posterior direction. The acoustic parameters analysis during the follow-up period showed that F1 and F2 were not significantly different of the patients with subtotal or total glossectomy over time. Conclusions Speech disorders in TSCC patients is common and persistent. Less residual tongue volume led to worse speech-related QoL, indicating that surgically restoring the length of the tongue and strengthening tongue extension postoperatively may be important.

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Section: Introductionmentioning

confidence: 79%

Speech disorders in patients with Tongue squamous cell carcinoma: A longitudinal observational study based on a questionnaire and acoustic analysis

et al. 2023

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“…Often, each tongue movement is scored separately and a calculated mean is assigned. Other tools focus on gross impairment of tongue mobility [ 62 ]. Each of these tools is usually administered during routine speech and swallowing rehabilitation assessments for proper quantitative functional outcome evaluations.…”

Section: Unique Points To Consider Regarding Tongue Reconstructionmentioning

confidence: 99%

Current status and evolution of microsurgical tongue reconstructions, part I

Choi

Alshomer

Kim

2022

Arch Craniofac Surg

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Reconstructive surgery in the management of head and neck cancer has evolved to include structure-specific approaches in which organ-specific treatment algorithms help optimize outcomes. Tongue cancer management and reconstruction are surgical challenges for which well-executed reconstructive plans should be completed promptly to avoid delaying any subsequently planned oncologic treatment. Crucial considerations in tongue cancer resection are the significant functional morbidity associated with surgical defects, particularly in terms of speech and swallowing, and the consequent negative impact on patients’ quality of life. With the evolution of microsurgical techniques and the development of the perforator flap concept, flap options can be tailored to the characteristics of various tongue defects. This has allowed the implementation of pliable flaps that can help restore tongue mobility and yield subsequent functional outcomes. Using an evolutional framework, we present this series of reviews related to tongue reconstruction. The first part of the review summarizes flap options and flap-related factors, such as volume and tissue characteristics. Related functional aspects are also presented, including tongue mobility, speech, and swallowing, as well as ways to evaluate and optimize these outcomes.

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“…Long-term data on functional and patient-reported HRQOL outcomes following reconstructive surgery of the jaw are lacking, which creates challenges in addressing supportive care needs in an evidence-based manner [ 19 ]. To date, most studies evaluating functional and/or HRQOL outcomes after jaw reconstruction surgery have been small, with limited follow-up [ 20 , 21 , 22 , 23 , 24 , 25 ]. Jacobsen and colleagues suggested that the persistent effects of (chemo)radiotherapy contribute to poor function and quality of life, despite the restoration of mandibular continuity after jaw reconstruction for osteoradionecrosis [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Radiotherapy on Functional and Health-Related Quality of Life Outcomes after Jaw Reconstruction

Venchiarutti

Dunn

Charters

et al. 2022

Cancers

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Long-term health-related quality of life (HRQOL) and functional outcomes following mandibular and maxillary reconstruction are lacking. To determine these outcomes, a cross-sectional study of patients with a history of cancer who underwent jaw reconstruction was undertaken. Participants were identified from a database of jaw reconstruction procedures at the Chris O’Brien Lifehouse (Sydney, Australia). Eligible patients had at least one month follow-up, were aged ≥18 years at surgery, and had history of malignancy. HRQOL was measured using the FACE-Q Head and Neck Cancer Module (FACE-Q H&N). Functional outcomes were measured using the FACE-Q H&N, MD Anderson Dysphagia Inventory (MDADI) and Speech Handicap Index (SHI). Ninety-seven questionnaires were completed (62% response rate). Mean age of respondents was 63.7 years, 61% were male, and 64% underwent radiotherapy. Treatment with radiotherapy was associated with worse outcomes across 10/14 FACE-Q H&N scales, three MDADI subscales and one composite score, and the SHI. Mean differences in scores between irradiated and non-irradiated patients exceeded clinically meaningful differences for the MDADI and SHI. Issues with oral competence, saliva, speaking, and swallowing worsened with increasing time since surgery. Younger patients reported greater concerns with appearance, smiling, speaking, and cancer worry. Women reported greater concerns regarding appearance and associated distress. History of radiotherapy substantially impacts HRQOL and function after jaw reconstruction. Age at surgery and gender were also predictors of outcomes and associated distress. Pre-treatment counselling of patients requiring jaw reconstruction may lead to improved survivorship for patients with head and neck cancer.

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Long-term functional outcomes and quality of life after partial glossectomy for T2 squamous cell carcinomas

Cited by 9 publications

References 24 publications

Speech disorders in patients with Tongue squamous cell carcinoma: A longitudinal observational study based on a questionnaire and acoustic analysis

Speech disorders in patients with Tongue squamous cell carcinoma: A longitudinal observational study based on a questionnaire and acoustic analysis

Current status and evolution of microsurgical tongue reconstructions, part I

Effect of Radiotherapy on Functional and Health-Related Quality of Life Outcomes after Jaw Reconstruction

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