Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, Guangdong, 510055, China.
Guangdong Provincial Key Laboratory of Stomatology, No.74, 2nd Zhongshan Road, Guangzhou, Guangdong, 510080, China.
BMC Oral Health. 2023 Apr 1;23(1):192. doi: 10.1186/s12903-023-02888-1.
Speech disorders are common dysfunctions in patients with tongue squamous cell carcinoma (TSCC) that can diminish their quality of life. There are few studies with multidimensional and longitudinal assessments of speech function in TSCC patients.
This longitudinal observational study was conducted at the Hospital of Stomatology, Sun Yat-sen University, China, from January 2018 to March 2021. A cohort of 92 patients (53 males, age range: 24-77 years) diagnosed with TSCC participated in this study. Speech function was assessed from preoperatively to one year postoperatively using the Speech Handicap Index questionnaire and acoustic parameters. The risk factors for postoperative speech disorder were analyzed by a linear mixed-effects model. A t test or Mann‒Whitney U test was applied to analyze the differences in acoustic parameters under the influence of risk factors to determine the pathophysiological mechanisms of speech disorders in patients with TSCC.
The incidence of preoperative speech disorders was 58.7%, which increased up to 91.4% after surgery. Higher T stage (P＜0.001) and larger range of tongue resection (P = 0.002) were risk factors for postoperative speech disorders. Among the acoustic parameters, F2/i/decreased remarkably with higher T stage (P = 0.021) and larger range of tongue resection (P = 0.009), indicating restricted tongue movement in the anterior-posterior direction. The acoustic parameters analysis during the follow-up period showed that F1 and F2 were not significantly different of the patients with subtotal or total glossectomy over time.
Speech disorders in TSCC patients is common and persistent. Less residual tongue volume led to worse speech-related QoL, indicating that surgically restoring the length of the tongue and strengthening tongue extension postoperatively may be important.
言语障碍是舌鳞状细胞癌（TSCC）患者常见的功能障碍，可降低其生活质量。目前，关于 TSCC 患者言语功能的多维和纵向评估研究较少。
本纵向观察性研究于 2018 年 1 月至 2021 年 3 月在中国中山大学口腔医院进行。共纳入 92 例（男性 53 例，年龄 24-77 岁）经组织学证实的 TSCC 患者。采用言语障碍指数问卷和声学参数对患者术前至术后 1 年的言语功能进行评估。采用线性混合效应模型分析术后言语障碍的危险因素。采用 t 检验或曼-惠特尼 U 检验分析受危险因素影响的声学参数差异，以确定 TSCC 患者言语障碍的病理生理机制。
术前言语障碍发生率为 58.7%，术后上升至 91.4%。较高的 T 分期（P＜0.001）和更大的舌切除范围（P = 0.002）是术后言语障碍的危险因素。在声学参数中，随着 T 分期的升高（P = 0.021）和舌切除范围的增大（P = 0.009），F2/i/值显著降低，表明舌前-后运动受限。随访期间的声学参数分析显示，对于行部分或全舌切除的患者，F1 和 F2 随时间的推移无显著差异。
TSCC 患者的言语障碍很常见且持续存在。残余舌体体积越小，与言语相关的生活质量越差，这表明术后重建舌体长度和加强舌体伸展可能很重要。
