Validation of an Intelligibility Assessment Tool in an Indian Language for Perceptual Speech Analysis in Oral Cancer Patients.

This study aimed to develop a speech intelligibility tool in Malayalam, an Indian language, based on the perceptual analysis. The tool had components of vowel, consonant, word, passage, and overall intelligibility. After face and content validation, a sample of 30 consecutive oral cancer patients underwent preliminary testing for internal consistency, inter- and intra-rater reliability, concurrent, and known-group validity. Subsequent validation was done in 80 T1-T4 patients from two centers. The scale had a high level of internal consistency; the Cronbach's alpha was 0.847 and good intra-rater and inter-rater agreement amongst all raters. There was a strong correlation between the Malayalam and the English passage. Pearson correlation coefficient of 0.646 proved concurrent validity. On known-group and subsequent validation, the tool showed expected differences between the treatment groups. The speech tool proved to be reliable and valid for perceptual evaluation of speech intelligibility in oral cancer patients.

Islanded facial artery musculo-mucosal flap for partial pharyngeal defect reconstruction after total laryngectomy: Case report.

BACKGROUND: Partial pharyngeal defect reconstruction after total laryngectomy with regional and free fasciocutaneous flaps has been described. However, mucosal flaps for such defects have not been reported. METHODS: An islanded facial artery musculo-mucosal (FAMM) flap was used to reconstruct a partial pharyngeal defect after total laryngectomy. Surgical, swallowing, and speech outcomes were analyzed at 6 months postoperatively. RESULTS: At 6 months, videofluoroscopy showed no post swallow residue, fistula, trachea-esophageal puncture leak, or stricture. Perceptual analysis of recorded cold speech, native language passage sample, and the intelligibility analysis was good. The patient had normal mouth opening and marginal mandibular nerve function. CONCLUSION: Islanded FAMM flap is ideal for partial pharyngeal defects, which cannot be closed primarily. Speech and swallowing outcomes were good. It provided a robust and predictable blood supply and adequate reach. There was no significant donor site morbidity. The musculo-mucosal flap replaced "like-with-like" tissue.