Volume 131, Issue 11 pp. 2497-2504

Head and Neck

Prediction of Speech, Swallowing, and Quality of Life in Oral Cavity Cancer Patients: A Pilot Study

Mustafa G. Bulbul MD,

Mustafa G. Bulbul MD

orcid.org/0000-0002-1148-1896

Department of Otolaryngology, Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, U.S.A.

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Michael Wu MD,

Michael Wu MD

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

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Derrick Lin MD,

Derrick Lin MD

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

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Kevin Emerick MD,

Kevin Emerick MD

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

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Daniel Deschler MD,

Daniel Deschler MD

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

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Jeremy Richmon MD,

Jeremy Richmon MD

orcid.org/0000-0002-6588-6549

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

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Tessa Goldsmith MA CCC-SLP, BRS-S,

Tessa Goldsmith MA CCC-SLP, BRS-S

Department of Speech, language and swallowing disorders, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.

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Joseph Zenga MD,

Corresponding Author

Joseph Zenga MD

[email protected]

Department of Otolaryngology, Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.

Send correspondence to Mark Varvares, MD, Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114. E-mail: [email protected]

Joseph Zenga, MD, Department of Otolaryngology, Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, WI 53226. E-mail: [email protected]

Sidharth V. Puram, MD, PhD, Department of Otolaryngology, Head and Neck Surgery Washington University in St Louis, St Louis, MO 63130. E-mail: [email protected]

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Sidharth V. Puram MD, PhD,

Corresponding Author

Sidharth V. Puram MD, PhD

[email protected]

Department of Otolaryngology, Head and Neck Surgery Washington University in St Louis, St Louis, Missouri, U.S.A.

Send correspondence to Mark Varvares, MD, Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114. E-mail: [email protected]

Joseph Zenga, MD, Department of Otolaryngology, Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, WI 53226. E-mail: [email protected]

Sidharth V. Puram, MD, PhD, Department of Otolaryngology, Head and Neck Surgery Washington University in St Louis, St Louis, MO 63130. E-mail: [email protected]

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Mark A. Varvares MD,

Corresponding Author

Mark A. Varvares MD

[email protected]

orcid.org/0000-0002-6570-5672

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

Send correspondence to Mark Varvares, MD, Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114. E-mail: [email protected]

Joseph Zenga, MD, Department of Otolaryngology, Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, WI 53226. E-mail: [email protected]

Sidharth V. Puram, MD, PhD, Department of Otolaryngology, Head and Neck Surgery Washington University in St Louis, St Louis, MO 63130. E-mail: [email protected]

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Mustafa G. Bulbul MD,

Mustafa G. Bulbul MD

orcid.org/0000-0002-1148-1896

Department of Otolaryngology, Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, U.S.A.

Search for more papers by this author

Michael Wu MD,

Michael Wu MD

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

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Derrick Lin MD,

Derrick Lin MD

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

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Kevin Emerick MD,

Kevin Emerick MD

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

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Daniel Deschler MD,

Daniel Deschler MD

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

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Jeremy Richmon MD,

Jeremy Richmon MD

orcid.org/0000-0002-6588-6549

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

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Tessa Goldsmith MA CCC-SLP, BRS-S,

Tessa Goldsmith MA CCC-SLP, BRS-S

Department of Speech, language and swallowing disorders, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.

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Joseph Zenga MD,

Corresponding Author

Joseph Zenga MD

[email protected]

Department of Otolaryngology, Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.

Send correspondence to Mark Varvares, MD, Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114. E-mail: [email protected]

Joseph Zenga, MD, Department of Otolaryngology, Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, WI 53226. E-mail: [email protected]

Sidharth V. Puram, MD, PhD, Department of Otolaryngology, Head and Neck Surgery Washington University in St Louis, St Louis, MO 63130. E-mail: [email protected]

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Sidharth V. Puram MD, PhD,

Corresponding Author

Sidharth V. Puram MD, PhD

[email protected]

Department of Otolaryngology, Head and Neck Surgery Washington University in St Louis, St Louis, Missouri, U.S.A.

Send correspondence to Mark Varvares, MD, Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114. E-mail: [email protected]

Joseph Zenga, MD, Department of Otolaryngology, Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, WI 53226. E-mail: [email protected]

Sidharth V. Puram, MD, PhD, Department of Otolaryngology, Head and Neck Surgery Washington University in St Louis, St Louis, MO 63130. E-mail: [email protected]

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Mark A. Varvares MD,

Corresponding Author

Mark A. Varvares MD

[email protected]

orcid.org/0000-0002-6570-5672

Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

Send correspondence to Mark Varvares, MD, Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA 02114. E-mail: [email protected]

Joseph Zenga, MD, Department of Otolaryngology, Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, WI 53226. E-mail: [email protected]

Sidharth V. Puram, MD, PhD, Department of Otolaryngology, Head and Neck Surgery Washington University in St Louis, St Louis, MO 63130. E-mail: [email protected]

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First published: 21 April 2021

https://doi.org/10.1002/lary.29573

Citations: 11

Editor's Note: This Manuscript was accepted for publication on April 09, 2020.

This study was funded through departmental funds at Massachusetts Eye and Ear.

The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives/Hypothesis

To investigate the impact of specific treatment-related variables on functional and quality of life outcomes in oral cavity cancer (OCC) patients.

Study Design

Retrospective Cohort.

Methods

Patients with primary OCC at least 6 months after resection and adjuvant therapy were included. Patients completed surveys including the Speech Handicap Index (SHI), M.D. Anderson Dysphagia Inventory (MDADI), and Functional Assessment of Cancer Therapy-Head and Neck (FACT-HN). Performance Status Scale (PSS) and tongue mobility scale were completed to allow provider-rated assessment of speech and tongue mobility, respectively. Additional details regarding treatment were also collected. These data were used to generate a predictive model using linear regression.

Results

Fifty-three patients with oral tongue and/or floor of mouth (FOM) resection were included in our study. In multivariable analysis, greater postoperative tongue range of motion (ROM) and time since treatment improved SHI. Flap reconstruction and greater postoperative tongue ROM increased MDADI and PSS (eating and speech). A larger volume of resected tissue was inversely correlated with PSS (diet and speech). Tumor site was an important predictor of PSS (all sections). There were no statistically significant predictors of FACT-HN.

Conclusions

In this pilot study, we propose a battery of tools to assess function in OCC patients treated with surgery. Using the battery of tools we propose, our results show that a surgical endpoint that preserves tongue mobility and employs flap reconstruction resulted in better outcomes, whereas those with greater volume of tissue resected and FOM involvement resulted in poorer outcomes. Larger prospective studies are needed to validate our findings.

Level of Evidence

3 Laryngoscope, 131:2497–2504, 2021

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Volume131, Issue11

November 2021

Pages 2497-2504

Prediction of Speech, Swallowing, and Quality of Life in Oral Cavity Cancer Patients: A Pilot Study

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

REFERENCES

Citing Literature

References

Information

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Prediction of Speech, Swallowing, and Quality of Life in Oral Cavity Cancer Patients: A Pilot Study

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

REFERENCES

Citing Literature

References

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