Abstract
This chapter begins with a summary of head and neck cancer treatment and its impact on speech function. The reader is introduced to various assessment modalities and tools. These include subjective ratings, clinician-driven and patient-driven assessments, as well as population-based perceptions of speech. The chapter covers speech outcomes following surgery and chemoradiation and concludes with current tools available to address speech function.
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References
Bandura, A. (1997). Self-efficacy the exercise of control. New York, NY: W. H. Freeman and Company.
Bjordal, K., Hammerlid, E., Ahlner-Elmqvist, M., de Graeff, A., Boysen, M., & Evensen, J. F. (1999). Quality of life in head and neck cancer patients: Validation of the European Organization for Research and Treatment of cancer quality of life questionnaire-H&N35. Journal of Clinical Oncology, 17(3), 1008–1019.
Borggreven, P. A., Verdonck-de Leeuw, I., Langendijk, J. A., Doornaert, P., Koster, M. N., de Bree, R., & Leemans, C. R. (2005). Speech outcome after surgical treatment for oral and oropharyngeal cancer: A longitudinal assessment of patients reconstructed by a microvascular flap. Head & Neck, 27(9), 785–793. https://doi.org/10.1002/hed.20236
Bressman, T., Jacobs, H., Quintero, J., & Irish, J. C. (2009). Speech outcomes for partial Glossectomy surgery: Measures of speech articulation and listener perception. Canadian Journal of Speech-Language Pathology and Audiology, 33(4), 204–210.
Canadian Cancer Society’s Advisory Committee on Cancer Statistics. (2015). Canadian cancer statistics 2015. Toronto, ON: Canadian Cancer Society. Retrieved from http://www.cancer.ca/en/cancer-information/cancer-type/
Chi, A. C., Day, T. A., & Neville, B. W. (2015). Oral cavity and oropharyngeal squamous cell carcinoma–an update. CA: A Cancer Journal for Clinicians, 65(5), 401–421. https://doi.org/10.3322/caac.21293
Cohan, D. M., Popat, S., Kaplan, S. E., Rigual, N., Loree, T., & Hicks, W. L. (2009). Oropharyngeal cancer: Current understanding and management. Current Opinion in Otolaryngology & Head and Neck Surgery, 17(2), 88–94. https://doi.org/10.1097/MOO.0b013e32832984c0
Cohen, E. E., LaMonte, S. J., Erb, N. L., Beckman, K. L., Sadeghi, N., Hutcheson, K. A., … Pratt-Chapman, M. L. (2016). American Cancer Society head and neck cancer survivorship care guideline. CA: A Cancer Journal for Clinicians, 66(3), 203–239. https://doi.org/10.3322/caac.21343
Colangelo, L. A., Logemann, J. A., & Rademaker, A. W. (2000). Tumor size and pretreatment speech and swallowing in patients with resectable tumors. Otolaryngology-Head and Neck Surgery, 122(5), 653–661. https://doi.org/10.1067/mhn.2000.104014
Connoly, J. H. (1986). 1986 Connolly intelligibility: A linguistic review.pdf. British Journal of Disorders of Communication, 21, 371–376.
Dios, P. D., Feijoo, J. F., Ferreiro, M. C., & Alvarez, J. A. (1994). Functional consequences of partial Glossectomy. Journal of Oral and Maxillofacial Surgery, 52, 12–14.
Dwivedi, R. C., Kazi, R. A., Agrawal, N., Nutting, C. M., Clarke, P. M., Kerawala, C. J., … Harrington, K. J. (2009). Evaluation of speech outcomes following treatment of oral and oropharyngeal cancers. Cancer Treatment Reviews, 35(5), 417–424. https://doi.org/10.1016/j.ctrv.2009.04.013
Dwivedi, R. C., Rose, S. S., Chisholm, E. J., Kerawala, C. J., Clarke, P. M., Nutting, C. M., … Kazi, R. (2012). Development and validation of first-ever speech-specific perceptual speech evaluation tool for patients with head and neck cancer: The London speech evaluation (LSE) scale. Head & Neck, 34(1), 94–103. https://doi.org/10.1002/hed.21683
Dwivedi, R. C., St Rose, S., Chisholm, E. J., Bisase, B., Amen, F., Nutting, C. M., … Kazi, R. (2012). Evaluation of speech outcomes using English version of the Speech Handicap Index in a cohort of head and neck cancer patients. Oral Oncology, 48(6), 547–553. https://doi.org/10.1016/j.oraloncology.2012.01.001
Dwivedi, R. C., St Rose, S., Chisholm, E. J., Clarke, P. M., Kerawala, C. J., Nutting, C. M., … Harrington, K. J. (2016). 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, 38(5), 670–676. https://doi.org/10.1002/hed.23956
Elfring, T., Boliek, C. A., Winget, M., Paulsen, C., Seikaly, H., & Rieger, J. M. (2014). The relationship between lingual and hypoglossal nerve function and quality of life in head and neck cancer. Journal of Oral Rehabilitation, 41(2), 133–140. https://doi.org/10.1111/joor.12116
Elghouche, A., Shokri, T., Qin, Y., Wargo, S., Citrin, D., & Van Waes, C. (2016). Unilateral cervical polyneuropathies following concurrent Bortezomib, Cetuximab, and radiotherapy for head and neck cancer. Case Reports in Otolaryngology, 2016, 2313714. https://doi.org/10.1155/2016/2313714
Epstein, J. B., Wilkie, D. J., Fischer, D. J., Kim, Y. O., & Villines, D. (2009). Neuropathic and nociceptive pain in head and neck cancer patients receiving radiation therapy. Head & Neck Oncology, 1, 26. https://doi.org/10.1186/1758-3284-1-26
Fisher, H. B., & Logemann, J. A. (1971). The fisher-Logemann test of articulation competence. Boston, MA: Houghton Mifflin.
Furia, C. L. B., Kowalski, L. P., Latorre, M. R. D. O., Angelis, E. C., Martins, N. M. S., Barros, A. P. B., & Ribeiro, K. C. B. (2001). Speech intelligibility after Glossectomy and speech rehabilitation. Archives of Otolaryngology – Head & Neck Surgery, 127, 877–883.
Georgian, D. A., Logemann, J. A., & Fisher, H. B. (1982). Compensatory articulation patterns of a surgically treated oral cancer patient. Journal of Speech and Hearing Disorders, 47(2), 154–159.
Govender, R., Breeson, L., Tuomainen, J., & Smith, C. H. (2013). Speech and swallowing rehabilitation following head and neck cancer: Are we hearing the patient’s voice? Our experience with ten patients. Clinical Otolaryngology, 38, 381–442.
Hiiemae, K. M., & Palmer, J. B. (2003). Tongue movements in feeding and speech. Critical Reviews in Oral Biology & Medicine, 14(6), 413–429.
Hoit, J. D., Lansing, R. W., Dean, K., Yarkosky, M., & Lederle, A. (2011). Nature and evaluation of dyspnea in speaking and swallowing. Seminars in Speech and Language, 32(1), 5–20. https://doi.org/10.1055/s-0031-1271971
Hutcheson, K. A., & Lewin, J. S. (2013). Functional assessment and rehabilitation: How to maximize outcomes. Otolaryngologic Clinics of North America, 46(4), 657–670. https://doi.org/10.1016/j.otc.2013.04.006
Hutcheson, K. A., Lewin, J. S., Barringer, D. A., Lisec, A., Gunn, G. B., Moore, M. W., & Holsinger, F. C. (2012). Late dysphagia after radiotherapy-based treatment of head and neck cancer. Cancer, 118(23), 5793–5799. https://doi.org/10.1002/cncr.27631
Jacobi, I., Navran, A., van der Molen, L., Heemsbergen, W. D., Hilgers, F. J., & van den Brekel, M. W. (2016). Radiation dose to the tongue and velopharynx predicts acoustic-articulatory changes after chemo-IMRT treatment for advanced head and neck cancer. European Archives of Oto-Rhino-Laryngology, 273(2), 487–494. https://doi.org/10.1007/s00405-015-3526-8
Jacobi, I., van der Molen, L., Huiskens, H., van Rossum, M. A., & Hilgers, F. J. (2010). Voice and speech outcomes of chemoradiation for advanced head and neck cancer: A systematic review. European Archives of Oto-Rhino-Laryngology, 267(10), 1495–1505. https://doi.org/10.1007/s00405-010-1316-x
Jacobi, I., van Rossum, M. A., van der Molen, L., Hilgers, F. J., & van den Brekel, M. W. (2013). Acoustic analysis of changes in articulation proficiency in patients with advanced head and neck cancer treated with Chemoradiotherapy. Annals of Otology, Rhinology & Laryngology, 122(12), 754–762.
Kraaijenga, S. A., Oskam, I. M., van Son, R. J., Hamming-Vrieze, O., Hilgers, F. J., van den Brekel, M. W., & van der Molen, L. (2016). Assessment of voice, speech, and related quality of life in advanced head and neck cancer patients 10-years+ after chemoradiotherapy. Oral Oncology, 55, 24–30. https://doi.org/10.1016/j.oraloncology.2016.02.001
Krisciunas, G. P., Platt, M., Trojanowska, M., Grillone, G. A., Haines, P. C., & Langmore, S. E. (2016). A novel in vivo protocol for molecular study of radiation-induced fibrosis in head and neck cancer patients. Annals of Otology, Rhinology & Laryngology, 125(3), 228–234. https://doi.org/10.1177/0003489415607527
Laaksonen, J. P., Loewen, I. J., Wolfaardt, J., Rieger, J., Seikaly, H., & Harris, J. (2009). Speech after tongue reconstruction and use of a palatal augmentation prosthesis: An acoustic case study. Canadian Journal of Speech-Language Pathology and Audiology, 33(4), 196–203.
Laaksonen, J. P., Rieger, J., Happonen, R. P., Harris, J., & Seikaly, H. (2010). Speech after radial forearm free flap reconstruction of the tongue: A longitudinal acoustic study of vowel and diphthong sounds. Clinical Linguistics & Phonetics, 24(1), 41–54. https://doi.org/10.3109/02699200903340758
Lam Tang, J., Rieger, J., & Wolfaardt, J. (2008). A review of functional outcomes related to prosthetic treatment after maxillary and mandibular reconstruction in patients with head and neck cancer. International Journal of Prosthodontics, 21, 337–354.
Lazarus, C. L., Husaini, H., Hu, K., Culliney, B., Li, Z., Urken, M., … Harrison, L. (2014). Functional outcomes and quality of life after chemoradiotherapy: Baseline and 3 and 6 months post-treatment. Dysphagia, 29(3), 365–375. https://doi.org/10.1007/s00455-014-9519-8
Levelt, W. J. M. (1989). Speaking: From intention to articulation. Cambridge, MA: The MIT Press.
Lin, Y. S., Jen, Y. M., & Lin, J. C. (2002). Radiation-related cranial nerve palsy in patients with nasopharyngeal carcinoma. Cancer, 95(2), 404–409. https://doi.org/10.1002/cncr.10668
Loewen, I. J., Boliek, C. A., Harris, J., Seikaly, H., & Rieger, J. M. (2010). Oral sensation and function: A comparison of patients with innervated radial forearm free flap reconstruction to healthy matched controls. Head & Neck, 32(1), 85–95. https://doi.org/10.1002/hed.21155
Mády, K., Sader, R., Hoole, P. H., Zimmermann, A., & Horch, H. H. (2009). Speech evaluation and swallowing ability after intra-oral cancer. Clinical Linguistics & Phonetics, 17(4–5), 411–420. https://doi.org/10.1080/0269920031000079921
Markkanen-Leppanen, M., Isotalo, E., Makitie, A. A., Asko-Seljavaara, S., Pessi, T., Suominen, E., & Haapanen, M. L. (2006). Changes in articulatory proficiency following microvascular reconstruction in oral or oropharyngeal cancer. Oral Oncology, 42(6), 646–652. https://doi.org/10.1016/j.oraloncology.2005.11.004
Massengill, R., Maxwell, S., & Pickrell, K. (1970). An analysis of articulation following partial and total glossectomy. Journal of Speech and Hearing Disorders, 35, 170–173.
McEwen, S. E., Davis, A. M., Jones, J. M., Martino, R., Poon, I., Rodriguez, A. M., & Ringash, J. (2015). Development and preliminary evaluation of a rehabilitation consult for survivors of head and neck cancer: An intervention mapping protocol. Implementation Science, 10, 6. https://doi.org/10.1186/s13012-014-0191-z
McKinstry, A., & Perry, A. (2003). Evaluation of speech in people with head and neck cancer: A pilot study. International Journal of Language & Communication Disorders, 38(1), 31–46. https://doi.org/10.1080/1368282021000014877
Metcalfe, C. W., Lowe, D., & Rogers, S. N. (2014). What patients consider important: Temporal variations by early and late stage oral, oropharyngeal and laryngeal subsites. Journal of Cranio-Maxillofacial Surgery, 42(5), 641–647. https://doi.org/10.1016/j.jcms.2013.09.008
Miller, R. M., & Groher, M. E. (1993). Speech-language pathology and dysphagia: A brief historical perspective. Dysphagia, 8, 180–184.
Mittal, B. B., Kepka, A., Mahadevan, A., Kies, M., Pelzer, H., List, M. A., … Logemann, J. (2001). Tissue/dose compensation to reduce toxicity from combined radiation and chemotherapy for advanced head and neck cancers. International Journal of Cancer, 96(Suppl), 61–70. https://doi.org/10.1002/ijc.10360
Morrish, E. C. E. (1988). Compensatory articulation in a subject with total glossectomy. British Journal of Disorders of Communication, 23, 13–22.
Morton, R. (2003). Studies in the quality of life of head and neck cancer patients: Results of a two- year longitudinal study and a comparative cross-sectional cross-cultural survey. Laryngoscope, 113, 1091–1103.
Namin, A. W., & Varvares, M. A. (2016). Functional outcomes of sensate versus insensate free flap reconstruction in oral and oropharyngeal reconstruction: A systematic review. Head & Neck, 38(11), 1717–1721. https://doi.org/10.1002/hed.24494
Nicoletti, G., Soutar, D. S., Jackson, M. S., Wrench, A. A., Robertson, G., & Robertson, C. (2004). Objective assessment of speech after surgical treatment for oral cancer: Experience from 196 selected cases. Plastic and Reconstructive Surgery, 113(1), 114–125. https://doi.org/10.1097/01.PRS.0000095937.45812.84
Pauloski, B. R., Logemann, J. A., Colangelo, L. A., Rademaker, A. W., McConnel, F. M. S., Heise, M. A., … Esclamado, R. (1998). Surgical variables affecting speech in treated patients with Oral and oropharyngeal cancer. Laryngoscope, 108, 908–916.
Perry, A., & Frowen, J. (2006). Speech and swallowing function in head and neck cancer patients: What do we know? Cancer Forum, 30(3), 178–183.
Perry, A. R., Shaw, M. A., & Cotton, S. (2003). An evaluation of functional outcomes (speech, swallowing) in patients attending speech pathology after head and neck cancer treatment(s): Results and analysis at 12 months post-intervention. Journal of Laryngology & Otology, 117(5), 368–381. https://doi.org/10.1258/002221503321626410
Peterson, G. E., & Barney, H. L. (1952). Control methods used in a study of the vowels. The Journal of the Acoustical Society of America, 24(2),175–184.
Piagkou, M., Demesticha, T., Skandalakis, P., & Johnson, E. O. (2011). Functional anatomy of the mandibular nerve: Consequences of nerve injury and entrapment. Clinical Anatomy, 24(2), 143–150. https://doi.org/10.1002/ca.21089
Radford, K., Woods, H., Lowe, D., & Rogers, S. N. (2004). A UK multi-Centre pilot study of speech and swallowing outcomes following head and neck cancer. Clinical Otolaryngology, 29, 376–381.
Redford, M. A. (2015). The handbook of speech production. West Sussex, UK: Wiley Blackwell.
Rieger, J., Bohle, G., Huryn, J., Lam Tang, J., Harris, J., & Seikaly, H. (2009). Surgical reconstruction versus prosthetic Obturation of extensive soft palate defects: A comparison of speech outcomes. International Journal of Prosthodontics, 22, 566–572.
Rieger, J., Dickson, N., Lemire, R., Bloom, K., Wolfaardt, J., Wolfaardt, U., & Seikaly, H. (2006). Social perception of speech in individuals with oropharyngeal reconstruction. Journal of Psychosocial Oncology, 24(4), 33–51. https://doi.org/10.1300/J077v24n04_03
Rieger, J. M., Zalmanowitz, J. G., Li, S. Y., Tang, J. L., Williams, D., Harris, J., & Seikaly, H. (2008). Speech outcomes after soft palate reconstruction with the soft palate insufficiency repair procedure. Head & Neck, 30(11), 1439–1444. https://doi.org/10.1002/hed.20884
Rinkel, R. N., Verdonck-de Leeuw, I. M., Doornaert, P., Buter, J., de Bree, R., Langendijk, J. A., … Leemans, C. R. (2016). Prevalence of swallowing and speech problems in daily life after chemoradiation for head and neck cancer based on cut-off scores of the patient-reported outcome measures SWAL-QOL and SHI. European Archives of Oto-Rhino-Laryngology, 273(7), 1849–1855. https://doi.org/10.1007/s00405-015-3680-z
Robertson, S. J., & Thomson, F. (1986). Working with dysarthrics: A practical guide to therapy for dysarthria. Bicester: Winslow Press.
Rogers, S. N., Laher, S. H., Overend, L., & Lowe, D. (2002). Importance-rating using the University of Washington quality of life questionnaire in patients treated by primary surgery for oral and oro-pharyngeal cancer. Journal of Cranio-Maxillofacial Surgery, 30(2), 125–132. https://doi.org/10.1054/jcms.2001.0273
Schuster, M., & Stelzle, F. (2012). Outcome measurements after oral cancer treatment: Speech and speech-related aspects–an overview. Oral and Maxillofacial Surgery, 16(3), 291–298. https://doi.org/10.1007/s10006-012-0340-y
Seikaly, H., Rieger, J., Wolfaardt, J., Moysa, G., Harris, J., & Jha, N. (2003). Functional outcomes after primary oropharyngeal cancer resection and reconstruction with the radial forearm free flap. Laryngoscope, 113, 897–904.
Shipley, K. G., & McAfee, J. G. (2004). Assessment in speech-language pathology. Clifton Park, NY: Delmar Learning.
Skelly, M. (1973). Glossectomee speech rehabilitation. Springfield, IL: Charles Thomas.
Su, W. F., Hsia, Y. J., Chang, Y. C., Chen, S. G., & Sheng, H. (2003). Functional comparison after reconstruction with a radial forearm free flap or a pectoralis major flap for cancer of the tongue. Otolaryngology-Head and Neck Surgery, 128(3), 412–418. https://doi.org/10.1067/mhn.2003.38
Tschiesner, U. (2012). Preservation of organ function in head and neck cancer. GMS Current Topics in Otorhinolaryngology – Head and Neck Surgery, 11, 1–18.
Tschiesner, U., Rogers, S., Dietz, A., Yueh, B., & Cieza, A. (2010). Development of ICF core sets for head and neck cancer. Head & Neck, 32(2), 210–220. https://doi.org/10.1002/hed.21172
Tschiesner, U., Sabariego, C., Linseisen, E., Becker, S., Stier-Jarmer, M., Cieza, A., & Harreus, U. (2013). Priorities of head and neck cancer patients: A patient survey based on the brief ICF core set for HNC. European Archives of Oto-Rhino-Laryngology, 270(12), 3133–3142. https://doi.org/10.1007/s00405-013-2446-8
Urken, M. L., Moscoso, J. F., Lawson, W., & Biller, H. F. (1994). A systematic approach to functional reconstruction of the Oral cavity following partial and Total Glossectomy. Archives of Otolaryngology – Head & Neck Surgery, 120, 589–601.
WHO. (2014). Head and Neck Cancer: Union for International Cancer Control 2014 Review of Cancer Medicines of the WHO List of Essential Medicines. 2014 Review of Cancer Medicines of the WHO List of Essential Medicines. Retrieved from http://www.who.int/selection_medicines/committees/expert/20/applications/cancer/en/
Yorkston, K., Beukelman, D., & Traynor, C. (1984). Assessment of intelligibility of dysarthric speech. Portland, OR: CC Publications.
Zuydam, A. C., Lowe, D., Brown, J. S., Vaughan, E. D., & Rogers, S. N. (2005). Predictors of speech and swallowing function following primary surgery for oral and oropharyngeal cancer. Clinical Otolaryngology, 30, 428–437.
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Constantinescu, G., Rieger, J.M. (2019). Speech Deficits Associated with Oral and Oropharyngeal Carcinomas. In: Doyle, P. (eds) Clinical Care and Rehabilitation in Head and Neck Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-04702-3_16
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