Long-term functional outcomes and quality of life after partial glossectomy for T2 squamous cell carcinomas

Abstract Introduction: Partial glossectomy and reconstruction strategy for malignant tongue tumors influences speech and swallowing. Objective: The aim of this retrospective study was to evaluate long-term functional outcomes after partial glossectomy for pT2 mobile tongue carcinomas with a maximum dimension between 2 and 3 cm. Different reconstruction strategies (with or without pedicled flap) were compared. Methods: Twenty-two patients with at least 12 months followup were included. Clinician-based and self-reported instruments were used to analyze tongue motility, speech intelligibility and articulation, swallowing, and quality of life. Results: Patients with a higher tongue motility had better articulation and lower dysphagia. Avoiding pedicled flap reconstruction seemed to guarantee lower impairment of speech and swallowing. Worse functional outcomes induced a lower quality of life. Conclusion: Partial glossectomy results in tongue motility impairment and consequently alterations of oral functions. Since the type of reconstruction impacts long-term outcomes, it should be adequately planned before surgery.

Long-term functional outcomes and quality of life after partial glossectomy for T2 squamous cell carcinomas.

INTRODUCTION: Partial glossectomy and reconstruction strategy for malignant tongue tumors influences speech and swallowing. OBJECTIVE: The aim of this retrospective study was to evaluate long-term functional outcomes after partial glossectomy for pT2 mobile tongue carcinomas with a maximum dimension between 2 and 3cm. Different reconstruction strategies (with or without pedicled flap) were compared. METHODS: Twenty-two patients with at least 12 months followup were included. Clinician-based and self-reported instruments were used to analyze tongue motility, speech intelligibility and articulation, swallowing, and quality of life. RESULTS: Patients with a higher tongue motility had better articulation and lower dysphagia. Avoiding pedicled flap reconstruction seemed to guarantee lower impairment of speech and swallowing. Worse functional outcomes induced a lower quality of life. CONCLUSION: Partial glossectomy results in tongue motility impairment and consequently alterations of oral functions. Since the type of reconstruction impacts long-term outcomes, it should be adequately planned before surgery.

Validation and Reliability of the Italian Version of the Speech Handicap Index.

BACKGROUND: Speech problems negatively affect the quality of life of patients with oral and oropharyngeal cancer. An appropriate self-rating questionnaire named Speech Handicap Index (SHI) was developed for these individuals. The aim of this study was the cross-cultural adaptation and the validation of the Italian version of the SHI. METHODS: Fifty-two patients surgically treated for oral or oropharyngeal cancer and 100 healthy individuals without speech articulation disorders were included in the study. An Italian version of the SHI was cross-culturally adapted. Internal consistency, test-retest reliability, construct, and clinical and group validity were calculated. RESULTS: Cronbach's alpha coefficient was 0.977. The test-retest reliability was excellent (r between 0.883 and 0.998). There was a good correlation between the total SHI score and the overall speech quality item (p < 0.001), and between the former and speech intelligibility and articulation scales (p < 0.001). The SHI was able to distinguish between patients and healthy subjects (p < 0.001). There was a statistically significant correlation between the total SHI score and tumor stage (p = 0.003). CONCLUSIONS: The Italian version of the SHI showed high values of reliability and validity scores. It is a good instrument to evaluate the impact of speech impairment in patients with oral and oropharyngeal cancer.