Journal of Speech and Hearing Research Vol.36 267-276 April 1993.
© American Speech-Language-Hearing Association
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Speech and Swallowing Function After Anterior Tongue and Floor of Mouth Resection With Distal Flap Reconstruction

Barbara Roa Pauloski 1
Jeri A. Logemann 1
Alfred W. Rademaker 2
Fred M. S. McConnel 3
Mary Anne Heiser 4
Salvatore Cardinale 4
Donald Shedd 4
Jan Lewin 5
Shan R. Baker 5
Darlene Graner 6
Barbara Cook 6
Frank Milianti 6
Sharon Collins 7

Theresa Baker 8
1 Northwestern University Evanston, IL
2 Northwestern University Cancer Center Biometry Section Chicago, IL
3 Emory University Atlanta, GA
4 Roswell Park Memorial Institute Buffalo, NY
5 University of Michigan Ann Arbor, MI
6 Edward Hines VA Hospital Hines, IL
7 Loyola University Medical Center Maywood, IL
8 Illinois Cancer Center Chicago, IL

The purpose of this study was to assess the postoperative functioning of oral cancer patients with resections of the anterior tongue and floor of mouth, reconstructed with distal flap closure. Speech and swallowing performance was assessed for 11 men and 5 women preoperatively and at 1 and 3 months postoperatively following a standardized protocol. Speech tasks included an audio recording of a brief conversation and of a standard articulation test; swallowing function was examined using video-fluoroscopy. Data were also collected on the number and duration of speech/swallowing treatment sessions, as well as the amount and duration of radiation therapy. Statistical analyses revealed that patients demonstrated a significant and severe impairment in speech and swallow functioning after surgery, with no recovery of function by 3 months post-healing. The degree of impairment in these patients may be related to the adynamic character of the distal flap used for reconstruction. Lack of improvement at the 3-month evaluation may be related to either the timing of postoperative radiation therapy or the low rate (44%) and amount of speech/swallowing treatment provided to these patients.

KEY WORDS: videofluoroscopy, dysphagia, postsurgical cancer, Intelligibility, articulation

Submitted on March 25, 1992
Accepted on September 30, 1992


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