Speech Deficits Associated with Oral and Oropharyngeal Carcinomas

Constantinescu, Gabriela; Rieger, Jana

doi:10.1007/978-3-030-04702-3_16

Cited by 6 publications

(3 citation statements)

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“…За период с 2010 по 2020 г. на 28,58 % увеличилось количество впервые диагностированных злокачественных заболеваний органов полости рта и ротоглотки [2]. Положение осложняется тем, что 65-70 % больных с данной патологией поступают для специализированного лечения уже с местно-распространенными процессами, в то время, когда им показано комбинированное лечение с обязательным хирургическим компонентом [3,4].…”

Section: Introductionunclassified

The Role of Computer-Aided Diagnosis in Speech Restoration in Patients with Cancer of the Oral Cavity and Oropharynx after Hemiglosectomy: a Prospective Comparative Study

Krasavina,

Choynzonov,

Kulbakin

et al. 2023

Bulletin of Rehabilitation Medicine

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INTRODUCTION. Oral cavity and oropharyngeal cancers usually require extensive surgeries accompanied by damages to anatomical structures and impaired speech function. AIM. To compare the effectiveness and terms of speech rehabilitation in patients with cancer of the oral cavity and oropharynx using various speech restoration techniques. MATERIALS AND METHODS. We studied the effectiveness and length of speech rehabilitation in 140 patients with stages II–IV oral cavity and oropharyngeal cancer. The age of the patients ranged from 24 to 70 years. All the patients underwent hemiglosectomy. Combined modality treatment and postoperative speech rehabilitation were performed according to the technique developed in the Department of Head and Neck Tumors of the Oncology Research Institute. Speech rehabilitation effectiveness was studied on the basis of subjective and objective evaluation of speech using the computer-software complex (OnkoSpeech v 1.0). RESULTS AND DISCUSSION. Impaired speech function of patients was observed before starting combined modality treatment and manifested as a change in the prosodic system of speech and subjective communication difficulties associated with the presence of a tumor. After surgery, all the patients demonstrated impaired speech function, ranging from distorted pronunciation to the complete absence of verbal communication. Speech rehabilitation started 8 to 29 days after surgery: in the study group I, Me = 9.6, in the study group II, Me = 9.8, values did not have statistically significant differences (p 0.05). At the beginning of speech rehabilitation, to restore activity and coordinate the work of articulatory apparatus muscles and speech expiration, special complexes of articulation and breathing exercises followed by sound pronunciation correction were performed. Postoperative speech rehabilitation resulted in the improvement of speech function in 100 % of cases. In group II, where the correction of sound pronunciation was performed on the basis of speech diagnosis data using the OnkoSpeech v 1.0 computer-software complex, it was possible to achieve a better result of sound pronunciation correction of all the studied sounds, except for hissing (lingual-frontal) [sh], [zh], [shch], [ch]. CONCLUSION. The use of the OnkoSpeech v1. ± software package for speech computer-aided diagnosis made it possible to objectively evaluate and quantify the effectiveness of the correction of the sound pronunciation of six phonemes of the Russian language, improve the results of the correction of sound pronunciation and reduce the time of speech therapy.

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Section: Introductionunclassified

The Role of Computer-Aided Diagnosis in Speech Restoration in Patients with Cancer of the Oral Cavity and Oropharynx after Hemiglosectomy: a Prospective Comparative Study

Krasavina,

Choynzonov,

Kulbakin

et al. 2023

Bulletin of Rehabilitation Medicine

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“…В России с 2008 по 2018 г. отмечалось увеличение заболеваемости раком полости рта и ротоглотки [3] устойчивый характер и поддаются лишь частичной коррекции [2,[4][5][6]. Нарушение речевой функции для большинства больных является тяжелой психологической травмой, которая ставит их перед необходимостью менять привычный образ жизни, порой профессию.…”

Section: Introductionunclassified

Speech Rehabilitation of Patients With Oral Cavity and Oropharyngeal Cancers After Reconstructive Surgery

et al. 2020

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Oral cavity and oropharyngeal cancers usually require extensive surgeries accompanied by damages to anatomical structures and impaired speech function. The use of reconstructive-plastic techniques to replace defects after surgical resection allows the creation of a favorable functional basis for speech restoration.The purpose of the study was to compare the effectiveness and terms of speech restoration in patients with oral cavity and oropharyngeal cancers after surgical treatment using various reconstructive surgery techniques to restore postoperative defects.Material and Methods. Speech rehabilitation results were analyzed in 56 patients with stage II–IV oral cavity and oropharyngeal cancers. The age of the patients ranged from 26 to 70 years. The patients underwent either hemiglossectomy or glossectomy followed by reconstructive surgery. Postoperative speech rehabilitation was performed according to the technique developed in the Department of Head and Neck Tumors of the Cancer Research Institute. Speech function was assessed before starting treatment, at the beginning of treatment and after completion of speech rehabilitation.Results. After surgery, all patients demonstrated impaired speech function, ranging from distorted pronunciation to the complete absence of verbal communication for 5 (71.4%) and 4 (80%) patients from Ib and IIb respectively. Speech rehabilitation started 16 to 32 days after surgery. Restoration of the activity and coordination of the articulatory apparatus muscles, speech exhalation and reconstructed tongue was followed by a sound pronunciation. Postoperative speech rehabilitation allowed improvement of speech function in 100 % of cases (56 patients). A complete speech restoration was achieved for 7 patients (12.5%). The majority of these patients were from the group with hemiglossectomy. In the group of patients with glossectomy, the amplitude and coordination of movements, which could be achieved by performing articulation exercises for the reconstructed tongue, depended on the size of the remaining part of their own tissues.Conclusion. Good values of all studied parameters were observed in patients, who underwent hemiglossectomy followed by reconstruction with a free revascularized flap. No statistically significant differences between the studied parameters were found in patients, who underwent glossectomy. Speech restoration parameters were significantly better in the group of patients with hemiglossectomy and reconstruction with a free revascularized flap than in the group of patients with glossectomy).

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“…Пациент может считать себя здоровым в том случае, если после проведенного комбинированного лечения он остается способным к нормальной жизни и трудовой деятельности, что особенно актуально для больных раком полости рта и ротоглотки, учитывая значение речевого общения в жизни человека. Речевая реабилитация дает человеку возможность свободно общаться, вернуться к прежнему социальному статусу и продолжить трудовую деятельность [6,9,11,12].…”

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Voice Rehabilitation After Surgery for Oral and Oropharyngeal Cancer

2019

SSMJ

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Целью нашего исследования является улучшение качества жизни больных после хирургического этапа комбинированного лечения рака органов полости рта и ротоглотки. Материал и методы. Изучены результаты речевой реабилитации 50 больных раком органов полости рта и ротоглотки II-III стадии опухолевого процесса, которым выполнено хирургическое вмешательство в объеме резекции ½ языка. Возраст пациентов варьировал от 33 до 70 лет, из них 37 человек (74 %)-наиболее трудоспособного возраста до 60 лет. Все больные получали комбинированное лечение и послеоперационную речевую реабилитацию в НИИ онкологии Томского национального исследовательского медицинского центра РАН. Реабилитационные мероприятия проводились по методике, разработанной в отделении опухолей головы и шеи НИИ онкологии. Выполнялись дыхательные упражнения, артикуляционная гимнастика для мышц щек, губ, языка, нижней челюсти и коррекция нарушений звукопроизношения. Состояние речевой функции оценивалось до и после реабилитации с использованием речевого материала, который содержал текст со смысловой нагрузкой, отдельные слова, слоги и бессмысленный набор звуков. Результаты и их обсуждение. В послеоперационном периоде у всех пациентов наблюдалось резкое ограничение подвижности культи языка, очень низкая разборчивость речи, отмечалось нарушение произношения звуков, полное или частичное отсутствие интонационного рисунка, замедление темпа речи. Проведение послеоперационной речевой реабилитации, основанной на увеличении подвижности культи языка и коррекции звукопроизношения, позволило в срок от 5 до 30 (медиана 22,1) дней улучшить состояние речевой функции путем восстановления произношения: заднеязычных звуков [К; Кь; Г; Гь]-в 78-94 %, переднеязычных [Т; Ть; Д; Дь]-в 74-80 %, свистящих [С, Сь]-в 56 % случаев. На основе проведенного исследования авторы делают вывод, о том, что всем больным раком органов полости рта и ротоглотки после хирургического этапа лечения для улучшения состояния речевой функции необходимо проведение речевой реабилитации с учетом объема операции, возникших нарушений и индивидуальных особенностей пациента. Ключевые слова: рак органов полости рта и ротоглотки, нарушения речевой функции, речевая реабилитация, качество жизни. Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

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Speech Deficits Associated with Oral and Oropharyngeal Carcinomas

Cited by 6 publications

References 60 publications

The Role of Computer-Aided Diagnosis in Speech Restoration in Patients with Cancer of the Oral Cavity and Oropharynx after Hemiglosectomy: a Prospective Comparative Study

The Role of Computer-Aided Diagnosis in Speech Restoration in Patients with Cancer of the Oral Cavity and Oropharynx after Hemiglosectomy: a Prospective Comparative Study

Speech Rehabilitation of Patients With Oral Cavity and Oropharyngeal Cancers After Reconstructive Surgery

Voice Rehabilitation After Surgery for Oral and Oropharyngeal Cancer

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