Essay about Oral Cancer and Speech

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In all languages, the construction of speech revolves around the tongue. Articulation of this organ is required to communicate 18 of the 23 consonants in the English language (Kaipa, Robb, O’Beirne, and Allison, 2012). The following research topic explores the speech lucidity of patients who have undergone an operation called a glossectomy. Due to cancers or other illnesses in the oval cavity, a glossectomy is preformed to remove an individual’s tongue. A partial removal is preferred as it allows for a smoother rehabilitation, but a complete removal is often necessary. The National Cancer Institute estimated that 42,000 people would develop oral or oropharyngeal cancer in 2014. Out of that, they predict that over 30% will develop cancer of the tongue (Stone, Langguth, Woo, Chen, & Prince, 2014). With these cancers becoming so prevalent, it is important to become knowledgeable in the therapy that follows a glossectomy. The research presented will study patients who have experienced the procedure, and whether they are capable of producing legible speech. It will also look at the alterations in speech required to produce normal sounds.
Literature Review Hutcheson and Lewin (2013) introduced the functional outcomes of oral and oropharyngeal cancers. In oral cancers of the tongue, the primary impairment is articulation. For individuals who have treated advanced stage oral tumors, more than 90% of their speech is intelligible. The glossectomy greatly effects their speech resonance. The process of swallowing involves five cranial nerves and more than 25 muscles, and can easily become damaged during the intensive surgery. It is the most crucial factor in the well being of a patient. In order to plan successive supportive care, a pretreatment functional assessment is critical. The assessment will allow physicians to predict reasonable outcomes and fabricate the correct route of therapy to boost functionality. In constructing surgical aids, it is essential to put detail into the volume and contour of the flap. In preventative care, incorporating swallowing techniques that prevent periods of nothing per oral (NPO) have also been shown to improve functionality (Hutcheson & Lewin, 2013). Kaipa et al. (2012) provided information on the types of treatments for oropharyngeal cancers. Chemoradiotherapy is the first line of defense, but if it proves unresponsive then a glossectomy must be completed. A partial glossectomy uses the individual’s mucous membrane to recreate part of their tongue. While a total glossectomy removes the entire organ to the root, replacing it with a muscular flap. Previous studies have shown that shape greatly influences function of the new tongue, the protuberant shape being the most successful. Broader flaps have shown improvements in recovery time. Their study followed a 31-year old female who was recovering from a total glossectomy, reconstructed with a right rectus abdominus myocutaneous free flap. Three separate sets of speech samples were accumulated one month apart. The study was centered on vowel productions, which involved prolongation of vowels for about five seconds; and consonant-vowel (CV) productions, which paired 17 syllable-initial consonants with three vowels creating 51 total types. A pool of 30 adults with normal hearing listened to each sound and attributed it to one of the 51 CVs. The results show that consonant and vowel articulation after the procedure may not happen in unison, as vowel pronunciation occurs at a more rapid pace (Kaipa et al, 2012). A study done by Bressmann, Jacobs, Quintero, and Irish (2009) evaluated the speech characteristics of patients from smaller and larger post partial glossectomies, an area which has not been highly researched. The characteristics included: an assessment of consonant production, in which the individuals recorded 80 monosyllabic words that each represented a consonant in the English language and were judged as normal or distorted; an assessment of
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