Artopoulou Ioli Ioanna, Dereka Xanthippi, Papalexopoulos Dimokritos, Kouri Maria, Giannakopoulos Nikolaos Nikitas
Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
Support Care Cancer. 2025 Feb 22;33(3):215. doi: 10.1007/s00520-025-09241-y.
To evaluate the effect of palatal augmentation prosthesis (PAP) in improving speech intelligibility, swallowing efficacy, masticatory function, patients' perception, and overall quality of life (QoL) in HNC survivors with partial or total glossectomy.
The systematic review was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO). The focused question was constructed according to the PICO (participant, intervention, comparison, and outcome) approach, and a three-stage screening in PubMed, Cochrane, Scopus, and Google Scholar databases with Medical Subject Heading (MeSH) terms was performed. The National Institute of Health (NIH) tool, "Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group," was employed for risk of bias assessment, and the data was synthesized qualitatively, according to the Synthesis without Meta-Analysis (SWiM) reporting guideline.
The initial search resulted in 131 articles, 80 were screened based on title and abstract, 11 full text articles were assessed for eligibility, and 9 articles were evaluated. Eight studies (88.9%) were characterized as fair and one as good. The total sample size included 176 participants. The "before" assessment was performed post-operatively, before PAP insertion, and the "after" at a time point ranging from after PAP insertion to a mean time of 9.3 (10.6) months, with a follow-up period ranging from 2 weeks to 82 months (mean time of 13.7 (17.3) months). Speech intelligibility was evaluated in eight studies. Six studies assessed swallowing and deglutition. Lingual movement dynamics of the center of the tongue, mastication ability, and patients' reported experience with PAP were each evaluated in one study. QoL assessment was performed in two studies. The results of this systematic review indicate that PAP has a significant effect in improving speech intelligibility, swallowing efficacy, masticatory function, patients' perceived outcomes, and overall QoL in HNC survivors with partial or total glossectomy.
Due to the particular defect site-related disabilities, patients with tongue resection could benefit from PAP prostheses. However, future studies evaluating the role of PAP in alleviating speech and swallowing by means of current methods of assessment, as well as more explicit patient's perceived treatment outcomes and QoL evaluations, are essential.
评估腭部增高假体（PAP）对部分或全舌切除术的头颈癌（HNC）幸存者语音清晰度、吞咽功能、咀嚼功能、患者感受及总体生活质量（QoL）的改善效果。
本系统评价按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行，并在国际系统评价前瞻性注册库（PROSPERO）中注册。根据PICO（参与者、干预措施、对照和结局）方法构建聚焦问题，并使用医学主题词（MeSH）在PubMed、Cochrane、Scopus和谷歌学术数据库中进行三阶段筛选。采用美国国立卫生研究院（NIH）工具“无对照组的前后研究质量评估工具”进行偏倚风险评估，并根据非Meta分析的综合报告指南（SWiM）对数据进行定性综合分析。
初步检索得到131篇文章，基于标题和摘要筛选出80篇，评估了11篇全文文章的 eligibility，最终纳入9篇文章进行评价。8项研究（88.9%）质量为中等，1项为良好。总样本量包括176名参与者。“术前”评估在术后、PAP植入前进行，“术后”评估在PAP植入后至平均9.3（10.6）个月的时间点进行，随访期为2周-82个月（平均13.7（17.3）个月）。8项研究评估了语音清晰度。6项研究评估了吞咽和咀嚼。舌中心的舌运动动力学、咀嚼能力以及患者报告的PAP使用体验各在1项研究中进行了评估。2项研究进行了生活质量评估。本系统评价结果表明，PAP对改善部分或全舌切除术的HNC幸存者的语音清晰度、吞咽功能、咀嚼功能、患者感受及总体生活质量有显著效果。
由于特定的与缺损部位相关的残疾，舌切除患者可从PAP假体中获益。然而，未来有必要通过当前的评估方法评估PAP在改善语音和吞咽方面的作用，以及进行更明确的患者感受治疗结局和生活质量评估。
