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Siberian Scientific Medical Journal

2019 year, number 6

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.