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Voice rehabilitation after surgery for oral and oropharyngeal cancer

https://doi.org/10.15372/SSMJ20190608

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 V> 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 correc 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    I [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.

About the Authors

E. A. Krasavina
Cancer Research Institute, Tomsk National Research Medical Center of RAS
Russian Federation

Elena Aleksandrovna Krasavina - candidate of biological sciences.

634009, Tomsk, 5, Kooperativny ln., 5



L. N. Balatskaya
Cancer Research Institute, Tomsk National Research Medical Center of RAS
Russian Federation

Lidiya Nikolaevna Balatskaya - doctor of biological sciences.

634009, Tomsk, 5, Kooperativny ln., 5



E. L. Choynzonov
Cancer Research Institute, Tomsk National Research Medical Center of RAS
Russian Federation

Evgeniy Lkhamatsyrenovich Choynzonov - doctor of medical sciences, professor, academician of the RAS.

634009, Tomsk, 5, Kooperativny ln., 5



D. E. Kulbakin
Cancer Research Institute, Tomsk National Research Medical Center of RAS
Russian Federation

 Denis Evgenievich Kulbakin - candidate of medical sciences.

634009, Tomsk, 5, Kooperativny ln., 5



References

1. Gerasimenko N.V Rehabilitation of cancer patients. Mosraw: Meditsina, 1988. 270 p. [In Russian].

2. Kaprin A.V., Starinskiy V.V., Petrova G.V. Malignant neoplasms in Russia in 2016 (incidence and mortality). Moscow, 2018. 250 p. [In Russian].

3. Krasavina E.A., Balatskaya L.N., Choinzonov E.L. The speech rehabilitation of patients with cancer of oropharyngeal area after surgical stage of combined treatment. Zdravookhraneniye Rossiyskoy Federatsii = Health Care of the Russian Federation. 2015; 59 (4): 33-37. [In Russian].

4. Kulakov A.A., Chuchkov V.M., Matyakin E.G., Romanov I.S., Akhundov A.A., Mudunov A.M., Fedotenko S.P., Fedotov N.N., Podvyaznikov S.O., Kropotov M.A., Zharkov O.A., Chizhova A.V., Chuchkov M.V. Phonation and speech recovery in cancer patients with maxillary defects. Opukholi golovy i shei = Head and Neck Tumors. 2012; (1): 55-60. [In Russian].

5. Pis’mennyi V.I., Kulakova N.M., Pis’mennyi I.V. The logopedic help after surgical treatment the malignant tumours of oropharyngeal zone. Izvestiya Samarskogo nauchnogo tsentra Rossiyskoy akademii nauk = Proceedings of the Samara Scientific Center of the Russian Academy of Sciences. 2015; 17 (2): 622-627. [In Russian].

6. Svetitskiy P.V., Aedinova I.V., Volkova V.L., Nistra-tov G.P., Zykova T.A., Bogomolova O.A. Development of operations and forecasting its results in patients with cancer of the oral cavity and oropharynx. Mezhduna-rodnyy zhurnal prikladnykh i fundamental’nykh issledovaniy = International Journal of Applied and Basic Research. 2016; 7 (4): 572-574. [In Russian].

7. Sedakov I.E., Semikoz N.G., Chistyakov A.A., Stepanov A.I., Olendar’ E.M. Modern aspects of the treatment of patients with malignant neoplasms of the oropharyngeal zone. Novoobrazovanie = Neoplasm. 2018; 10 (4): 146-150. [In Russian]. doi: 10.26435/neoplasm.v10i4.262

8. Choinzonov E.L., Novikov V.A., Perel’muter V.M., Balatskaya L.N., Mukhamedov M.R., Klisho E.V., Syrkashev V.A., Avdeenko M.V Advances of current oncology in the treatment of malignant head and neck tumors. Byulleten’ Sibirskogo otdeleniya Rossiyskoy akademii meditsinskikh nauk = Bulletin of Siberian Branch of Russian Academy of Medical Sciences. 2012; 32 (1): 81-85. [In Russian].

9. Dwivedi R.C., Kazi R.A., Agrawal N., Nutting C.M., Clarke P.M., Kerawala C.J., Harrington K.J. Evaluation of speech outcomes following treatment of oral and oropharyngeal cancers. Cancer Treat. Rev. 2009; 35 (5): 417-424. doi: 10.1016/j.ctrv.2009.04.013

10. Dwivedi R.C., St Rose S., Chisholm E.J., Clarke P.M., Kerawala C.J., Nutting C.M., Rhys-Evans P.H., Kazi R., Harrington K.J. Acoustic parameters of speech: Lack of correlation with perceptual and questionnaire-based speech evaluation in patients with oral and oropharyngeal cancer treated with primary surgery. Head Neck. 2016; 38 (5): 670-676. doi: 10.1002/hed.23956

11. Constantinescu G., Rieger J.M. Speech deficits associated with oral and oropharyngeal carcinomas. Clinical Care and Rehabilitation in Head and Neck Cancer. 2019; 265-279. doi: 10.1007/978-3-030-04702-3_16

12. Webster K.T., Tippett D., Simpson M., Abrams R., Pietsch K., Herbert R.J., Eisele D.W., Gourin C.G. Speech-language pathology care and short- and long-term outcomes of oropharyngeal cancer treatment in the elderly. Laryngoscope. 2018; 128 (6): 1403-1411. doi: 10.1002/lary.26950


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