Speech intelligibility after glossectomy and speech rehabilitation

Background: Oral tumor resections cause articulation deficiencies, dependin g on the site, extent of resection, type of reconstruction, and tongue stum p mobility. Objectives: To evaluate the speech intelligibility of patients undergoing t otal, subtotal, or partial glossectomy, before and after speech therapy. Patients and Methods: Twenty-seven patients (24 men and 3 women), aged 34 t o 77 years (mean age, 56.5 years), underwent glossectomy. Tumor stages were T1 in 3 patients, T2 in 4, T3 in 8, T4 in 11, and TX in 1; node stages, NO in 15 patients, N1 in 5, N2a-c in 6, and N3 in 1. No patient had metastase s (MO). Patients were divided into 3 groups by extent of tongue resection, ie, total (group 1; n=6), subtotal (group 2; n=9), and partial (group 3; n= 12). Different phonological tasks were recorded and analyzed by 3 experienc ed judges, including sustained 7 oral vowels, vowel in a syllable, and the sequence vowel-consonant-vowel (VCV). The intelligibility of spontaneous sp eech (sequence story) was scored from 1 to 4 in consensus. All patients und erwent a therapeutic program to activate articulatory adaptations, compensa tions, and maximization of the remaining structures for 3 to 6 months. The tasks were recorded after speech therapy. To compare mean changes, analyses of variance and Wilcoxon tests were used. Results: Patients of groups 1 and 2 significantly improved their speech int elligibility (P < .05). Group 1 improved vowels, VCV, and spontaneous speec h; group 2, syllable, VCV, and spontaneous speech. Group 3 demonstrated bet ter intelligibility in the pretherapy phase, but the improvement after ther apy was not significant. Conclusions: Speech therapy was effective in improving speech intelligibili ty of patients undergoing glossectomy, even after major or resection. Diffe rent pretherapy ability between groups was seen, with improvement of speech intelligibility in groups land 2. The improvement of speech intelligibilit y in group 3 was not statistically significant, possibly because of the sma ll and heterogeneous sample.