Heller K S, Levy J, Sciubba J J
Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, New York.
Head Neck. 1991 Jul-Aug;13(4):340-3. doi: 10.1002/hed.2880130412.
To determine the type and extent of speech impairment to be expected following partial glossectomy, pre- and postoperative speech evaluations were performed on 10 patients undergoing surgery for carcinomas of the mobile tongue less than 3 cm in size. In addition, audiotapes of standardized speech samples were made at each evaluation. Preoperative speech evaluation revealed normal rates of verbal diadochokinesis without distortion in all 10 patients. Phonologic analysis was also normal in 9 of these patients. Postoperative evaluation revealed normal rates of verbal diadochokinesis in 6 patients and mild lingual distortion in 4. At 3 weeks postoperatively 1 patient had sibilant distortion and 1 patient overall slurring of speech. Evaluation of both of these patients at 6 months revealed that speech had returned to normal. Blinded comparison of the pre- and postoperative audiotapes revealed no change in 8 patients. In 2 patients the early postoperative tape was thought to "sound different" but the final postoperative tapes in all patients were judged to be normal. This study demonstrates that partial glossectomy for early carcinomas of the tongue can be performed with minimal, if any, permanent speech impairment.
为了确定部分舌切除术后预期的言语障碍类型和程度,对10例因活动部舌癌行手术治疗且肿瘤大小小于3厘米的患者进行了术前和术后言语评估。此外,每次评估时均录制了标准化言语样本的录音带。术前言语评估显示,所有10例患者的言语轮替运动速率正常,无发音扭曲。其中9例患者的语音分析也正常。术后评估显示,6例患者言语轮替运动速率正常,4例有轻度舌部发音扭曲。术后3周时,1例患者有咝音扭曲,1例患者有整体言语含糊不清。对这2例患者在6个月时的评估显示言语已恢复正常。对术前和术后录音带进行盲法比较发现,8例患者无变化。2例患者术后早期的录音带被认为“听起来不同”,但所有患者术后最终的录音带均被判定为正常。本研究表明,对于早期舌癌行部分舌切除术,即使有永久性言语障碍,也极为轻微。