4.3 Article

Volume and location of the defect as predictors of speech outcome after glossectomy: correlation with a classification

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CHURCHILL LIVINGSTONE
DOI: 10.1016/j.ijom.2021.02.026

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mouth neoplasms; head and neck cancer; glossectomy; speech intelligibility; classification

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The study found that speech outcomes after resection and reconstruction of the oral tongue were significantly influenced by the volume of defects and their location, especially in class II and III defects. The results highlight the importance of considering volume and location in predicting speech outcomes post-surgery.
The evaluation of speech outcomes after resection and reconstruction of the oral tongue remains largely unsystematic. A cross-sectional study was performed to analyse the speech outcomes of patients who underwent curative treatment with appropriate reconstruction. Sixty-nine patients were assessed for speech intelligibility and phonetics using a validated speech intelligibility assessment tool in the local language. Volume defects were classified as class I (less than one third), II (one third to half), III (half to two-thirds), or IV (two-thirds to total glossectomy). Defect location was defined as lateral, tip, or sulcus. The chi(2) test and Kruskal-Wallis test were used to test volume and location as predictors. Twenty-six patients had class I defects, 29 had class II defects, seven had class III defects, and seven had class IV defects. Twenty-two patients (31.9%) received adjuvant radiotherapy. Mean vowel, consonant, word, and paragraph intelligibility were 99.27%, 86.86%, 85.52%, and 88.72%, respectively. The incremental volume of the glossectomy defect was significantly correlated with speech intelligibility scores and phonatory alterations. In classes II and III, tip resection significantly affected interdental sounds. All patients in class III had affected alveolar and alveo-palatal sounds. The results positively corroborated the volume and location of the glossectomy defect to a classification system.

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