Articulatory function in glossectomized patients with immediate reconstruction using a free jejunum flap

Area of Science:

• Otorhinolaryngology
• Speech Pathology
• Oral and Maxillofacial Surgery

Background:

• Glossectomy, a surgical procedure involving tongue removal, significantly impacts postoperative articulation.
• Understanding the relationship between tumor location, extent of resection, and speech function is crucial for patient outcomes.

Purpose of the Study:

• To investigate the impact of glossectomy due to various oral tumors on postoperative articulation.
• To identify specific speech sound deficits related to tumor site and resection extent.
• To evaluate the influence of reconstructive techniques on speech intelligibility.

Main Methods:

• Speech audiometry using a modified Freiburger test was administered to 18 glossectomized patients.
• Articulatory function was assessed via overall scores, consonant production, and glossal sound production.
• Patients were categorized based on tumor location: tongue, anterior floor of mouth, and lateral floor of mouth.

Main Results:

• Patients with tongue and lateral floor of mouth tumors demonstrated excellent articulation, comparable to normative data.
• Tumors of the anterior floor of the mouth resulted in significantly lower overall articulation scores, particularly for plosive, affricative, and rear-tongue sounds.
• A weak negative correlation was observed between the extent of resection and postoperative articulation across all groups.

Conclusions:

• Tumor location, specifically the anterior floor of the mouth, is a critical determinant of poor postoperative articulation.
• Even uninvolved posterior tongue movement can be compromised after anterior resections, affecting speech.
• Objective assessment of postoperative function is essential for comparing reconstructive techniques, such as free jejunum flap, and guiding treatment decisions.