OBTURATOR PROSTHESES AFTER CANCER-SURGERY - AN APPROACH TO SPEECH OUTCOME ASSESSMENT

Purpose, This article describes a speech assessment protocol for patie nts using either obturator prostheses or speech aid prostheses for sur gically acquired defects due to cancer of the maxilla and/or soft pala te. Methods, This protocol is structured according to the executive su mmary of ''Disability in America: Toward a National Agenda For Prevent ion'' a report formulated by the Institute of Medicine that describes four levels of disorder: (1) pathology, (2) impairment, (3) functional limitation, and (4) disability. Assess ment instruments included (1) the Sentence Intelligibility Test to measure the rate and understandab ility of speech, (2) a speech physiology system to measure appropriate separation of the nasal/nasopharyngeal and oral compartments, (3) a 1 3-point interval scale to rate speech nasality, and (4) a scale to rat e self-perceptions of communication effectiveness. Results. The result s from two patients are reported to illustrate the outcome assessment protocol.