Speech diagnostics as an objective criterion for the effectiveness of speech restoration in patients with oropharyngeal cancer

The aim of this study was to analyze the method of speech computer diagnostics for an objective assessment of the effectiveness of speech rehabilitation therapy in patients with oropharyngeal cancer after surgical treatment. Material and methods. The prospective study included 155 patients with stage II – IV oropharyngeal cancer, who underwent surgery and speech rehabilitation at the Head and Neck Cancer Department of Cancer Research Institute (Tomsk). The age range of the patients was from 26 to 70 years with a median of 52 years. The patients were divided into 3 groups depending on the extent of surgery. Group I included 70 patients who underwent hemiglossectomy without tongue defect reconstruction. Group II consisted of 70 patients who underwent hemiglossectomy with reconstructive surgery. For the reconstruction of hemiglossectomy defect, the submental, radial forearm free, and medial sural perforator flaps, as well as anterolateral thigh fasciocutaneous flap were used. Group III included 15 patients who underwent glossectomy and reconstruction with pectoralis flaps and musculocutaneous anterolateral thigh flaps. After verification of oropharyngeal cancer and before starting treatment, speech of all patients was recorded using the «OncoSpeech v1.0» computer software. This recording is the basis for further speech diagnostics, as it allows to create a speech standard for each patient. The «OncoSpeech v1.0» computer software can evaluate the pronunciation of six phonemes of the Russian language [К], [S], [Т], [К’], [С’], [Т’]. In our study, we used the OncoLanguage system, which consists of 90 syllables, taking into account the different positions of phonemes in a syllable (at the beginning, in the middle, at the end). All sessions of audio recordings and their current quantitative assessment were automatically uploaded into the program. The second speech recording was performed after surgery when patients were admitted to speech rehabilitation therapy to assess the resulting pronunciation disorders of the studied phonemes. To assess the effectiveness of sound pronunciation correction, the last speech recording was performed after the completion of speech rehabilitation. Results. The speech function correction was performed on days 8 -39 after surgery according to the method developed in the Head and Neck Cancer Department of Tomsk Cancer Research Institute. The program of speech rehabilitation was compiled individually for each patient, depending on the patient’s health condition, age, extent of surgery and the results of speech computer diagnostics using the «OncoSpeech v1.0» computer software. Speech therapy was aimed at restoring the speech function of patients in the shortest time after surgery by activating and coordinating the movement of the lips, cheeks, stump of the tongue, root of the tongue and the lower jaw. The improvement in pronunciation of all six phonemes [К], [S], [Т], [К’], [S’], [Т’] was observed in 100% of patients. The data were expressed in quantitative values in a comparative aspect. The best values for all studied phonemes were observed in group II patients who underwent hemiglossectomy with reconstructive surgery. Conclusion. Speech diagnostics using the OncoSpeech v1.0 software package made it possible to quantitatively express the violation of the pronunciation in patients with oropharyngeal cancer as well as to objectively evaluate the effectiveness of the correction of the sound pronunciation of six phonemes. Key words: oropharyngeal cancer, hemiglossectomy, glossectomy, speech restoration, speech computer diagnostics, objective speech assessment, «OncoSpeech v1.0» Conflicts of interest. The authors have no conflicts of interest to declare. Funding. There was no funding for this study