SPEECH AND SWALLOWING IN IRRADIATED AND NONIRRADIATED POSTSURGICAL ORAL-CANCER PATIENTS

The effect of radiation on speech and swallowing function was assessed for 18 patients surgically treated for oral and oropharyngeal cancer. Nine patients received surgical intervention and postoperative radiat ion therapy, and nine received surgery only. Patients were matched reg arding percentage of oral tongue resected, percentage of tongue base r esected, locus of resection, and method of reconstruction. Speech and swallowing function was assessed before and at 1, 3, 6, and 12 months after surgery following a standardized protocol. Speech tasks included an audio recording of a brief conversation and of a standard articula tion test; swallowing function was examined with videofluoroscopy. Sta tistical testing indicated that overall speech function did not differ between the irradiated and nonirradiated patients. Irradiated patient s had significantly reduced oral and pharyngeal swallowing performance , specifically, longer oral transit times on paste boluses, lower orop haryngeal swallow efficiency, increased pharyngeal residue, and reduce d cricopharyngeal opening duration, Impaired function may be the resul t of radiation effects such as edema, fibrosis, and reduced salivary f low. Increased use of tongue range-of-motion exercises during and afte r radiation treatment may reduce the formation of fibrotic tissue in t he oral cavity and may improve pharyngeal clearance by maintaining ade quate tongue base-to-pharyngeal wall contact.