Skip to main content

Advertisement

SpringerLink
Log in

Development of a New Lingual Range-of-Motion Assessment Scale: Normative Data in Surgically Treated Oral Cancer Patients

  • Original Article
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

Surgical resection in oral cancer patients can result in altered speech, swallowing, and patient perception of quality of life (QOL). Oral surgery can result in reduced lingual range of motion (ROM). However, few studies have quantified the degree of lingual restriction after surgery. This pilot study describes a new measurement system to define tongue ROM in surgically treated tongue cancer patients. This measurement system was validated by comparing results in these treated surgical patients versus healthy individuals. This scale was further validated by correlating ROM with performance status, oral outcomes, and patient-rated QOL. Thirty-six patients who underwent oral tongue surgery and 31 healthy individuals were included. Tongue ROM was assessed using a novel ROM assessment system. This novel system was examined in these patients versus healthy subjects. This measurement tool was further validated by correlating tongue ROM in treated patients with performance status, oral outcomes, and patient-rated QOL. Tongue ROM was found to be significantly lower in the surgically treated patients than in the healthy individuals (p = 0.0001). Tongue ROM correlated with performance status, oral outcomes, and all QOL measures. This new tongue ROM measurement system defined tongue deficits in surgically treated oral cancer patients. This tool was validated by comparing results to those in healthy individuals, as well as by correlating tongue ROM to performance status, oral outcomes, and QOL. This measurement tool can be used to define baseline and postsurgery tongue ROM in oral cancer patients, as well as track change over time with recovery and therapy. Future studies should examine use of this measurement tool with other populations demonstrating tongue deficits.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Pauloski BR, et al. Speech and swallowing function after anterior tongue and floor of mouth resection with distal flap reconstruction. J Speech Hear Res. 1993;36(2):267–76.

    Article  CAS  PubMed  Google Scholar 

  2. Pauloski BR, et al. Speech and swallowing function after oral and oropharyngeal resections: one-year follow-up. Head Neck. 1994;16(4):313–22.

    Article  CAS  PubMed  Google Scholar 

  3. Pauloski BR, Logemann JA. Impact of tongue base and posterior pharyngeal wall biomechanics on pharyngeal clearance in irradiated postsurgical oral and oropharyngeal cancer patients. Head Neck. 2000;22(2):120–31.

    Article  CAS  PubMed  Google Scholar 

  4. Pauloski BR, et al. Surgical variables affecting speech in treated patients with oral and oropharyngeal cancer. Laryngoscope. 1998;108(6):908–16.

    Article  CAS  PubMed  Google Scholar 

  5. Furia CL, et al. Speech intelligibility after glossectomy and speech rehabilitation. Arch Otolaryngol Head Neck Surg. 2001;127(7):877–83.

    CAS  PubMed  Google Scholar 

  6. Rentschler GJ, Mann MB. The effects of glossectomy on intelligibility of speech and oral perceptual discrimination. J Oral Surg. 1980;38(5):348–54.

    CAS  PubMed  Google Scholar 

  7. Biazevic MG, et al. Survival and quality of life of patients with oral and oropharyngeal cancer at 1-year follow-up of tumor resection. J Appl Oral Sci. 2010;18(3):279–84.

    Article  PubMed  Google Scholar 

  8. Dwivedi RC, et al. An exploratory study of the influence of clinico-demographic variables on swallowing and swallowing-related quality of life in a cohort of oral and oropharyngeal cancer patients treated with primary surgery. Eur Arch Otorhinolaryngol. 2012;269(4):1233–9.

    Article  PubMed  Google Scholar 

  9. Yang ZH, et al. Quality of life of patients with tongue cancer 1 year after surgery. J Oral Maxillofac Surg. 2010;68(9):2164–8.

    Article  PubMed  Google Scholar 

  10. McConnel FM, et al. Functional results of primary closure vs flaps in oropharyngeal reconstruction: a prospective study of speech and swallowing. Arch Otolaryngol Head Neck Surg. 1998;124(6):625–30.

    Article  CAS  PubMed  Google Scholar 

  11. Suarez-Cunqueiro MM, et al. Speech and swallowing impairment after treatment for oral and oropharyngeal cancer. Arch Otolaryngol Head Neck Surg. 2008;134(12):1299–304.

    Article  PubMed  Google Scholar 

  12. Hanasono MM, et al. Impact of reconstructive microsurgery in patients with advanced oral cavity cancers. Head Neck. 2009;31(10):1289–96.

    Article  PubMed  Google Scholar 

  13. Urken ML, et al. A systematic approach to functional reconstruction of the oral cavity following partial and total glossectomy. Arch Otolaryngol Head Neck Surg. 1994;120(6):589–601.

    Article  CAS  PubMed  Google Scholar 

  14. Brown L, et al. A longitudinal study of functional outcomes after surgical resection and microvascular reconstruction for oral cancer: tongue mobility and swallowing function. J Oral Maxillofac Surg. 2010;68(11):2690–700.

    Article  PubMed  Google Scholar 

  15. Seikaly H, et al. Functional outcomes after primary oropharyngeal cancer resection and reconstruction with the radial forearm free flap. Laryngoscope. 2003;113(5):897–904.

    Article  PubMed  Google Scholar 

  16. Rieger JM, et al. Functional outcomes after surgical reconstruction of the base of tongue using the radial forearm free flap in patients with oropharyngeal carcinoma. Head Neck. 2007;29(11):1024–32.

    Article  PubMed  Google Scholar 

  17. Dodds WJ, Stewart ET, Logemann JA. Physiology and radiology of the normal oral and pharyngeal phases of swallowing. AJR Am J Roentgenol. 1990;154(5):953–63.

    Article  CAS  PubMed  Google Scholar 

  18. Shin YS, et al. Radiotherapy deteriorates postoperative functional outcome after partial glossectomy with free flap reconstruction. J Oral Maxillofac Surg. 2012;70(1):216–20.

    Article  PubMed  Google Scholar 

  19. Michiwaki Y, et al. Functional effects of intraoral reconstruction with a free radial forearm flap. J Craniomaxillofac Surg. 1990;18(4):164–8.

    Article  CAS  PubMed  Google Scholar 

  20. Imai S, Michi K. Articulatory function after resection of the tongue and floor of the mouth: palatometric and perceptual evaluation. J Speech Hear Res. 1992;35(1):68–78.

    Article  CAS  PubMed  Google Scholar 

  21. Chepeha DB, et al. Rectangle tongue template for reconstruction of the hemiglossectomy defect. Arch Otolaryngol Head Neck Surg. 2008;134(9):993–8.

    Article  PubMed  Google Scholar 

  22. Michi K, et al. Improvement of speech intelligibility by a secondary operation to mobilize the tongue after glossectomy. J Craniomaxillofac Surg. 1989;17(4):162–6.

    Article  CAS  PubMed  Google Scholar 

  23. Leder SB, et al. Can an oral mechanism examination contribute to the assessment of odds of aspiration? Dysphagia. 2013;28(3):370–4.

    Article  PubMed  Google Scholar 

  24. Husaini H, et al. Survey of functional assessments used by speech-language pathologists for oral cancer patients. Dysphagia. doi:10.1007/s00455-014-9520-2.

  25. List MA, et al. Quality of life and performance in advanced head and neck cancer patients on concomitant chemoradiotherapy: a prospective examination. J Clin Oncol. 1999;17(3):1020–8.

    CAS  PubMed  Google Scholar 

  26. List MA, Ritter-Sterr C, Lansky SB. A performance status scale for head and neck cancer patients. Cancer. 1990;66(3):564–9.

    Article  CAS  PubMed  Google Scholar 

  27. Schag C, Heinrich R, Ganz P. Karnofsky performance status scale revisited: reliability, validity and guidelines. J Clin Oncol. 1984;2:187–93.

    CAS  PubMed  Google Scholar 

  28. Belafsky PC, et al. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919–24.

    PubMed  Google Scholar 

  29. Chen AY, et al. The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson dysphagia inventory. Arch Otolaryngol Head Neck Surg. 2001;127(7):870–6.

    CAS  PubMed  Google Scholar 

  30. Dwivedi RC, et al. First report on the reliability and validity of speech handicap index in native English-speaking patients with head and neck cancer. Head Neck. 2011;33(3):341–8.

    PubMed  Google Scholar 

  31. Rinkel RN, et al. Speech Handicap Index in patients with oral and pharyngeal cancer: better understanding of patients’ complaints. Head Neck. 2008;30(7):868–74.

    Article  PubMed  Google Scholar 

  32. Lazarus CL, et al. Tongue strength as a predictor of functional outcomes and quality of life after tongue cancer surgery. Ann Otol Rhinol Laryngol. 2013;122(6):386–97.

    PubMed  Google Scholar 

  33. Lazarus CL, et al. Swallowing and tongue function following treatment for oral and oropharyngeal cancer. J Speech Lang Hear Res. 2000;43(4):1011–23.

    Article  CAS  PubMed  Google Scholar 

  34. Magne P, Gallucci GO, Belser UC. Anatomic crown width/length ratios of unworn and worn maxillary teeth in white subjects. J Prosthet Dent. 2003;89(5):453–61.

    Article  PubMed  Google Scholar 

  35. Connor NP, et al. Impact of conventional radiotherapy on health-related quality of life and critical functions of the head and neck. Int J Radiat Oncol Biol Phys. 2006;65(4):1051–62.

    Article  PubMed  Google Scholar 

  36. Kohler PF, Winter ME. A quantitative test for xerostomia. The Saxon test, an oral equivalent of the Schirmer test. Arthritis Rheum. 1985;28(10):1128–32.

    Article  CAS  PubMed  Google Scholar 

  37. Urken ML, Okay DJ. Reconstruction of the oral cavity following partial and total glossectomy. In: Urken ML, editor. Multidisciplinary head & neck reconstruction: a defect-oriented approach. New York: Wolters Kluwer/Lippincott Williams & Wilkins; 2010. p. 235–320.

    Google Scholar 

  38. Nicosia MA, et al. Age effects on the temporal evolution of isometric and swallowing pressure. J Gerontol A Biol Sci Med Sci. 2000;55(11):M634–40.

    Article  CAS  PubMed  Google Scholar 

  39. Weber C, et al. Limited mouth opening after primary therapy of head and neck cancer. Oral Maxillofac Surg. 2010;14(3):169–73.

    Article  PubMed  Google Scholar 

  40. Navazesh M, Christensen CM. A comparison of whole mouth resting and stimulated salivary measurement procedures. J Dent Res. 1982;61(10):1158–62.

    Article  CAS  PubMed  Google Scholar 

  41. Chen PH, et al. Prevalence of perceived dysphagia and quality-of-life impairment in a geriatric population. Dysphagia. 2009;24(1):1–6.

    Article  PubMed  Google Scholar 

  42. Furia CL, et al. Video fluoroscopic evaluation after glossectomy. Arch Otolaryngol Head Neck Surg. 2000;126(3):378–83.

    Article  CAS  PubMed  Google Scholar 

  43. Logemann JA et al. Speech and swallowing rehabilitation for head and neck cancer patients. Oncology (Williston Park), 1997;11(5):651–6, 659; discussion 659, 663–4.

  44. Lazarus C. Effects of radiotherapy on tongue strength in head and neck cancer patients. In: American Speech-Language-Hearing Association Annual Meeting 2005, San Diego, CA.

  45. Pauloski BR, et al. Speech and swallowing in irradiated and nonirradiated postsurgical oral cancer patients. Otolaryngol Head Neck Surg. 1998;118(5):616–24.

    CAS  PubMed  Google Scholar 

  46. McConnel FM, et al. Surgical variables affecting postoperative swallowing efficiency in oral cancer patients: a pilot study. Laryngoscope. 1994;104(1 Pt 1):87–90.

    CAS  PubMed  Google Scholar 

  47. Zelefsky MJ et al. Long-term subjective functional outcome of surgery plus postoperative radiotherapy for advanced stage oral cavity and oropharyngeal carcinoma. Am J Surg. 1996;171(2):258–61; discussion 262.

  48. Teguh DN, et al. Treatment techniques and site considerations regarding dysphagia-related quality of life in cancer of the oropharynx and nasopharynx. Int J Radiat Oncol Biol Phys. 2008;72(4):1119–27.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Thanks go to Sebastien Delice for his contribution of data input and to Eileen Stevens for her contributions with data accrual.

Conflict of interest

No authors have any conflict of interest or disclosures to acknowledge.

Author information

Authors and Affiliations

  1. Thyroid Head and Neck Cancer Foundation, New York, NY, USA

    C. L. Lazarus, H. Husaini, A. S. Jacobson, J. K. Mojica, D. Buchbinder, D. Okay & M. L. Urken

  2. Department of Otolaryngology Head and Neck Surgery, Mount Sinai Beth Israel, New York, NY, USA

    C. L. Lazarus, A. S. Jacobson, J. K. Mojica, D. Buchbinder, D. Okay & M. L. Urken

  3. Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    C. L. Lazarus, A. S. Jacobson, D. Buchbinder, D. Okay & M. L. Urken

  4. Thyroid Head and Neck Research Center, Mount Sinai Beth Israel, 10 Union Square East Suite 5B, New York, NY, 10003, USA

    C. L. Lazarus

Authors
  1. C. L. Lazarus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Husaini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. S. Jacobson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. K. Mojica
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Buchbinder
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. D. Okay
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. L. Urken
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. L. Lazarus.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lazarus, C.L., Husaini, H., Jacobson, A.S. et al. Development of a New Lingual Range-of-Motion Assessment Scale: Normative Data in Surgically Treated Oral Cancer Patients. Dysphagia 29, 489–499 (2014). https://doi.org/10.1007/s00455-014-9534-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-014-9534-9

Keywords

Search

Navigation