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Maria-Mercedes Suarez-Cunqueiro, DDS, PhD; Alexander Schramm, DDS, MD, PhD; Ralf Schoen, DDS, MD, PhD; Juan Seoane-Lestón, DDS, MD, PhD; Xosé-Luis Otero-Cepeda, PhD; Kai-Hendrik Bormann, DDS; Horst Kokemueller, MD, DDS; Marc Metzger, MD, DDS; Pedro Diz-Dios, DDS, MD, PhD; Nils-Claudius Gellrich, DDS, MD, PhD

Arch Otolaryngol Head Neck Surg. 2008;134(12):1299-1304.

Objectives  To assess the prevalence of speech and swallowing impairment after radical surgery for oral and oropharyngeal cancer from the patient's viewpoint and to examine the association of these functional alterations with selected clinical characteristics regarding patients, tumors, and oncologic treatment.

Design  Cross-sectional, multicenter study using a self-administered questionnaire.

Setting  Forty-three hospitals in Germany, Switzerland, and Austria.

Patients  A total of 3894 questionnaires about rehabilitation problems after treatment for oral and oropharyngeal squamous cell carcinoma were sent to patients. Of these, 1652 were filled out and returned, and 1334 (80.8%) met the inclusion criteria.

Main Outcome Measures  Morbidity associated with treatment of oral and oropharyngeal cancer.

Results  Speech problems were reported by 851 patients (63.8%), and swallowing problems were reported by 1006 patients (75.4%). The variables that presented a significant association with speech and swallowing impairment were sex, tumor location, pTNM stages, stage of tumor, treatment modality, and reconstruction type.

Conclusions  This survey, based on patient perception, suggests that those who undergo radiotherapy associated with the surgical removal of a tumor, have late-stage tumors (III-IV), or have tumors located in the floor of the mouth should be informed of the greater risk of persistent severe speech and swallowing problems.

Author Affiliations: Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany (Drs Suarez-Cunqueiro, Bormann, Kokemueller, and Gellrich); Department of Oral and Maxillofacial Surgery, German Federal Armed Forces Hospital, Ulm, Germany (Dr Schramm); Departments of Stomatology (Drs Suarez-Cunqueiro, Seoane-Lestón, and Diz-Dios) and Biostatistics (Dr Otero-Cepeda), University Santiago de Compostela, Santiago de Compostela, Spain; and Department of Oral and Maxillofacial Surgery, University Hospital Freiburg, Albert-Ludwigs-University, Freiburg, Germany (Drs Schoen and Metzger).

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