SPEECH AND SWALLOW FUNCTION AFTER TONSIL BASE OF TONGUE RESECTION WITH PRIMARY CLOSURE

Speech and swallowing function was examined in 11 patients who underwe nt surgical resection of greater than 1 cm of tongue base, tonsil, and faucial arch with mandible resected on the side of the tumor and reco nstruction by primary closure. Preoperatively and 1 and 3 months post- healing, high fidelity audio recordings were made of a 6- to 7-minute conversational speech sample, the sentence version of The Fisher Logem ann Test of Articulation Competence was administered, and videofluoros copic assessment of oropharyngeal swallow was conducted. All subjects exhibited changes in speech and swallowing function postoperatively, w ith little improvement during the study. Patients exhibited greatest d ifficulty on stop and fricative consonants and bolus propulsion. Compa rison with patients who received anterior tongue and floor of mouth re sections and distal flap reconstruction revealed consistently better s peech performance by the tonsil/base of tongue patients, although the same phonemes were affected. Swallow function was equally affected in the two groups. Results are discussed in terms of locus of surgical re section, nature of reconstruction, and need for swallowing therapy.