Assessment of Speech in Patients Undergoing Hemiglossectomy with Primary Closure and Radiotherapy - A Prospective Study.

Abstract

The oral cavity plays a pivotal role in the generation of speech. The treatment of oral squamous cell carcinoma of the tongue requires an aggressive approach, combining resective surgery along with radiation therapy, with long-lasting effects on the patient's ability to speak. This study was designed to assess speech in subjects with carcinoma of the tongue following hemiglossectomy with primary closure and radiotherapy. A prospective study was carried out in 20 subjects who underwent hemiglossectomy with primary closure for carcinoma of the tongue followed by radiotherapy. All subjects were evaluated for speech using 'Kannada Diagnostic Photo Articulation Test' before surgery, after surgery (on the 10th and 30th day), during radiation therapy after 15 fractions of radiation and after 1, 2 and 3 months following completion of radiotherapy. Statistical analysis was performed using SPSS software (v. 17.0). Significance levels were determined using ANOVA followed by Bonferroni correction. Intelligibility of speech was noted to be affected most at the one month follow-up visit after completion of radiotherapy (P < 0.001). The Kannada Diagnostic Photo Articulation Test proves to be a useful tool in assessing changes in speech, with results that can be replicated in further studies. The incidence of articulatory errors is increased following surgery and radiotherapy. Over time, the number of errors reduce and approach the baseline, indicating that although speech is indeed hampered by the treatment, with adequate speech therapy one can regain their preoperative articulation.