Longitudinal Recovery of Speech Motor Function Following Facial Transplantation: A Prospective Observational Study

Area of Science:

• Reconstructive surgery
• Speech-language pathology
• Biomechanics

Background:

• Facial transplantation restores appearance but speech outcomes are understudied.
• Limited data exists on the rate and extent of speech recovery after facial transplantation.
• Understanding speech recovery is crucial for patient counseling and intervention development.

Purpose of the Study:

• To describe the rate and extent of functional speech and lip recovery post-facial transplantation.
• To compare speech recovery in early versus late stages after surgery.
• To explore the relationship between kinematic measures and functional speech outcomes.

Main Methods:

• Evaluated four early and three late-stage recovery patients.
• Utilized Sentence Intelligibility Test for speech intelligibility.
• Employed Iowa Oral Performance Instrument for lip strength.
• Used 3D optical motion capture for kinematic lip and jaw function analysis.

Main Results:

• Speech intelligibility, speaking rate, and lip strength were below norms within two years post-surgery.
• Early recovery patients (0-24 months) showed faster improvements in clinical and kinematic measures than later-stage patients (36-60 months).
• Jaw and lip movement gains correlated with intelligibility improvements, but lip strength did not.

Conclusions:

• Speech and lip function recovery is gradual after facial transplantation, with the most significant gains occurring within the first two years.
• Kinematic measures of jaw and lip movement are associated with speech intelligibility.
• Findings support the development of interventions to improve motor speech function in facial transplant recipients.