Institute of Psychology, Christian-Albrechts-University Kiel, Olshausenstr. 62, 24118, Kiel, Germany.
Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Building B, D-24105, Kiel, Germany.
J Craniomaxillofac Surg. 2021 Nov;49(11):1072-1080. doi: 10.1016/j.jcms.2021.06.011. Epub 2021 Jun 22.
To analyze objective and subjective progression of speech intelligibility in oral cancer patients undergoing high-frequency speech therapy during early rehabilitation. Oral cancer patients in the Department of Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Kiel, Germany, participated in the study from March 2016 to November 2017. Speech intelligibility was analyzed preoperatively (t1), post radiation (t2), and post speech therapy (t3). Objective measures were the Munich Intelligibility Profile (Online) and the Frenchay Dysarthria Assessment-2 (FDA-2). Subjective measures were the Speech Handicap Index (SHI), the speech subscale of the EORTC QLQ-C30&HN35, and the WHO-5 Index II. For nine patients with complete data, progression analyses showed a non-existent-to-low intelligibility impairment at t1 (means/SDs: e.g. FDA-2: 8.96/0.11, SHI: 17.5/15.15), increasing towards t2 (means/SDs/p-values for difference from t1: e.g. FDA-2: 7.40/0.80/0.000, SHI: 21.7/14.24/0.213), and then decreasing towards t3, without ever reaching the initial level (means/SDs/p-values for difference from t1: e.g. FDA-2: 8.22/0.60/0.005, SHI: 23.5/15.85/0.481). The objective changes in intelligibility were significant; the subjective changes were not. Overall, the ability to speak intelligibly after oral cancer treatment follows a typical pattern. Therefore, high-frequency speech therapy in the early rehabilitation phase might be recommendable. It might help patients to adapt to their situation after surgery, and facilitates compensating for possible functional deficits.
分析口腔癌患者在早期康复高频言语治疗过程中言语可懂度的客观和主观进展。德国石勒苏益格-荷尔斯泰因州基尔大学医院颌面外科的口腔癌患者参与了这项研究,时间从 2016 年 3 月至 2017 年 11 月。术前(t1)、放疗后(t2)和言语治疗后(t3)分析言语可懂度。客观测量包括慕尼黑言语可懂度测试(在线版)和法国言语障碍评估-2 (FDA-2)。主观测量包括言语障碍指数(SHI)、EORTC QLQ-C30&HN35 言语分量表和 WHO-5 健康指数 II。对于 9 名数据完整的患者,进展分析显示 t1 时存在低至不存在的言语可懂度障碍(平均值/标准差:例如,FDA-2:8.96/0.11,SHI:17.5/15.15),t2 时逐渐增加(平均值/标准差/与 t1 差值的 p 值:例如,FDA-2:7.40/0.80/0.000,SHI:21.7/14.24/0.213),然后在 t3 时下降,从未达到初始水平(平均值/标准差/与 t1 差值的 p 值:例如,FDA-2:8.22/0.60/0.005,SHI:23.5/15.85/0.481)。言语可懂度的客观变化显著;主观变化不显著。总的来说,口腔癌治疗后说话清晰的能力遵循一种典型模式。因此,在早期康复阶段进行高频言语治疗可能是值得推荐的。它可以帮助患者适应手术后的情况,并有助于补偿可能的功能缺陷。