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Speech Intelligibility After Glossectomy and Speech Rehabilitation
Cristina L. B. Furia, SLP, MSc;
Luiz P. Kowalski, MD, PhD;
Maria R. D. O. Latorre, PhD;
Elisabete C. Angelis, SLP, PhD;
Nívia M. S. Martins, SLP;
Ana P. B. Barros, SLP;
Karina C. B. Ribeiro, DDS, MSc
Arch Otolaryngol Head Neck Surg. 2001;127:877-883.
Background Oral tumor resections cause articulation deficiencies, depending on
the site, extent of resection, type of reconstruction, and tongue stump mobility.
Objectives To evaluate the speech intelligibility of patients undergoing total,
subtotal, or partial glossectomy, before and after speech therapy.
Patients and Methods Twenty-seven patients (24 men and 3 women), aged 34 to 77 years (mean
age, 56.5 years), underwent glossectomy. Tumor stages were T1 in 3 patients,
T2 in 4, T3 in 8, T4 in 11, and TX in 1; node stages, N0 in 15 patients, N1
in 5, N2a-c in 6, and N3 in 1. No patient had metastases (M0). Patients were
divided into 3 groups by extent of tongue resection, ie, total (group 1; n
= 6), subtotal (group 2; n = 9), and partial (group 3; n = 12). Different
phonological tasks were recorded and analyzed by 3 experienced judges, including
sustained 7 oral vowels, vowel in a syllable, and the sequence vowel-consonant-vowel
(VCV). The intelligibility of spontaneous speech (sequence story) was scored
from 1 to 4 in consensus. All patients underwent a therapeutic program to
activate articulatory adaptations, compensations, and maximization of the
remaining structures for 3 to 6 months. The tasks were recorded after speech
therapy. To compare mean changes, analyses of variance and Wilcoxon tests
were used.
Results Patients of groups 1 and 2 significantly improved their speech intelligibility
(P<.05). Group 1 improved vowels, VCV, and spontaneous speech;
group 2, syllable, VCV, and spontaneous speech. Group 3 demonstrated better
intelligibility in the pretherapy phase, but the improvement after therapy
was not significant.
Conclusions Speech therapy was effective in improving speech intelligibility of
patients undergoing glossectomy, even after major resection. Different pretherapy
ability between groups was seen, with improvement of speech intelligibility
in groups 1 and 2. The improvement of speech intelligibility in group 3 was
not statistically significant, possibly because of the small and heterogeneous
sample.
From the Departments of Voice, Speech, and Swallowing Rehabilitation
(Drs Furia and Angelis and Mss Martins and Barros), Head and Neck Surgery
and Otorhinolaryngology (Dr Kowalski), and Cancer Registration and Statistics
(Drs Latorre and Ribeiro), Centro de Tratamento e Pesquisa Hospital do Câncer
A. C. Camargo, São Paulo, Brazil.
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Arch Otolaryngol Head Neck Surg. 2001;127(7):889-890.
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