VOICE REHABILITATION AFTER SURGERY FOR ORAL AND OROPHARYNGEAL CANCER
Elena Aleksandrovna KRASAVINA, Lidiya Nikolaevna BALATSKAYA, Evgeniy Lkhamatsyrenovich CHOYNZONOV, Denis Evgenievich KULBAKIN
Cancer Research Institute, Tomsk National Research Medical Center of RAS
Keywords: рак органов полости рта и ротоглотки, нарушения речевой функции, речевая реабилитация, качество жизни, oral and oropharyngeal cancer, impaired speech function, voice rehabilitation, quality of life
Abstract
The purpose of our study
was to improve the quality of life of patients after surgery for oral
and oropharyngeal cancer. Material and methods. Voice rehabilitation
outcomes in 50 patients with stage II-III oral and oropharyngeal cancer
were studied. All patients underwent resection of ½ of the tongue. The
patients were aged between 33 and 70 years, 70 % of them were up to 60
years. All patients received combined modality treatment and
postoperative voice rehabilitation in Cancer Research Institute of Tomsk
National Research Medical Center of RAS. The technique of voice
rehabilitation included breathing exercises, articulation gymnastics for
the muscles of the cheeks, lips, tongue, lower jaw and correction of
disturbances in sound pronunciation. A speech function was assessed
before and after rehabilitation using speech material that contained a
text with semantic load, individual words, syllables and a meaningless
set of sounds. Results and discussion. In the postoperative period, all
patients experienced a sharp restriction of the mobility of the stump of
the tongue, very low speech intelligibility, violation of the
pronunciation of sounds, complete or partial absence of intonation
pattern, and slowdown in the rate of speech. Postoperative voice
rehabilitation aimed at increasing the mobility of tongue stump and
correcting sound pronunciation made it possible to improve speech
function in the period from 5 to 30 days (median 22.1) by restoring the
pronunciation of the velar sounds [K, G] in 78-94 % of cases, alveolar
sounds [T, D] in 74-80 %, and whistling sound [C] in 56 % of cases.
Based on the study, the authors conclude that speech rehabilitation is
required for all patients, who underwent surgery for oral and
oropharyngeal cancer, taking into account the extent of surgery and
individual characteristics of the patients.
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