Objectives: Analysis of long-term speech and swallowing function and subjective quality of life (QOL) after primary resection and sentinel node biopsy (SNB) in patients with early stage (cT1/T2) oral squamous cell carcinomas (OSCC).
Material And Methods: Eighty-one consecutive patients treated primarily by transoral resection without flap reconstruction and SNB for a cT1/T2 OSCC were included. Completion neck dissection (CND) was indicated in case of occult disease in the sentinel nodes. Adjuvant radiation (aRT) was administered according to the ultimate lymph node status. All patients showed no evidence of disease at time of analysis. Speech and swallowing function were assessed using standardized clinical examinations (11-item, articulation test) and validated questionnaires on subjective QOL (MDADI, FIGS). Median follow-up was 60 months (range 13-159 months) after initial treatment.
Results: In all assessments for speech and swallowing, the entire study cohort achieved very high scores, with mean values located in the highest 10% of the scales. Neither tumor size nor site, age, pN-category, CND, and aRT had significant impact on functional outcomes and subjective QOL with the exception of lower scores in the global and physical scores of MDADI after CND or aRT, and articulation in the population over 60 years of age.
Conclusion: Transoral resection without reconstruction and SNB for early OSCC achieves excellent outcome with regard to speech, swallowing and subjective QOL.
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http://dx.doi.org/10.1016/j.oraloncology.2018.12.027 | DOI Listing |
Cureus
December 2024
Department of Anatomical Sciences, William Carey University College of Osteopathic Medicine, Hattiesburg, USA.
The digastric muscle is a suprahyoid muscle that is composed of an anterior belly and a posterior belly, which originate from the first and second pharyngeal arches, respectively, and they are innervated by the nerves of these arches. The digastric muscles are involved in the elevation of the hyoid bone and depression of the mandible during mastication, speech, and swallowing. In this report, we present the rare case of bilateral accessory anterior belly of the digastric muscles (ABDMs) that originated from the digastric fossa, medial to the anterior bellies.
View Article and Find Full Text PDFDysphagia
January 2025
Department of Head and Neck Surgery, Section of Speech Pathology & Audiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
Compensatory swallow strategies are recommended to improve swallow safety and efficiency; however, there is limited evidence on use in specific populations or their relationship to swallow study results. We sought to describe/explore strategy recommendations in an oncology practice and their relationship to Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) grades as a marker of clinical utility of the tool. This is a sub-study of a STARI-guided retrospective implementation evaluation at a single comprehensive cancer center.
View Article and Find Full Text PDFArch Rehabil Res Clin Transl
December 2024
Peninsula Hospital Center, Department of Speech-Language Pathology and Audiology, Far Rockaway, NY.
Objective: To determine if fatigue systematically effects the timing of swallowing events and to discuss underlying causes of fatigue other than peripheral neuromuscular fatigue.
Design: Pre-post within-subject repeated-measures design.
Setting: General acute care hospital and designated stroke center.
JPRAS Open
March 2025
Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, University Hospital Basel, Basel, Switzerland.
Background: The excision of oropharyngeal carcinoma of more than 50% of the soft palate followed by static reconstruction may result in functional deficits, including velopharyngeal insufficiency, swallowing, and speech difficulties. We describe a functional soft palate reconstruction technique aimed at restoring aeromechanical and acoustic functions, enabling swallowing without nasal regurgitation and speech with low nasalance.
Material And Methods: We developed a new operative technique, using muscle transfer and a free flap to create a dynamic reconstruction.
Am J Speech Lang Pathol
January 2025
Department of Therapy Services, University of Virginia Health System, Charlottesville.
Purpose: Research has shown that prolonged endotracheal intubation can increase risk of aspiration following extubation. This study examined the relationship between swallowing and intubation among patients with COVID-19. We investigated the association between the duration of intubation and time until an oral diet was safely initiated and the correlation between the length of intubation and reduced sensation with aspiration as seen on flexible endoscopic evaluation of swallowing (FEES)/videofluoroscopic swallowing study (VFSS).
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