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Hansen NJ, Woodman K, Buoy S, Mao S, Barbon CEA, Lai SY, Fuller CD, Hutcheson KA, Sanchez B. Tongue electrical impedance myography correlates with functional, neurophysiologic, and clinical outcome measures in long-term oropharyngeal cancer survivors with and without hypoglossal neuropathy: An exploratory study. Head Neck 2024; 46:581-591. [PMID: 38133080 PMCID: PMC10922903 DOI: 10.1002/hed.27618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND This pilot study analyzed correlations between tongue electrical impedance myography (EIM), standard tongue electromyography (EMG), and tongue functional measures in N = 4 long-term oropharyngeal cancer (OPC) survivors. METHODS Patients were screened for a supportive care trial (NCT04151082). Hypoglossal nerve function was evaluated with genioglossus needle EMG, functional measures with the Iowa oral performance instrument (IOPI), and multi-frequency tissue composition with tongue EIM. RESULTS Tongue EIM conductivity was higher for patients with EMG-confirmed cranial nerve XII neuropathy than those without (p = 0.005) and in patients with mild versus normal EMG reinnervation ratings (16 kHz EIM: p = 0.051). Tongue EIM correlated with IOPI strength measurements (e.g., anterior maximum isometric lingual strength: r2 = 0.62, p = 0.020). CONCLUSIONS Tongue EIM measures related to tongue strength and the presence of XII neuropathy. Noninvasive tongue EIM may be a convenient adjunctive biomarker to assess tongue health in OPC survivors.
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Affiliation(s)
- Nathan J. Hansen
- Department of Electrical and Computer Engineering, The University of Utah, Salt Lake City, Utah, USA
| | - Karin Woodman
- Department of Neurology, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Sheila Buoy
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Shitong Mao
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Carly E. A. Barbon
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Stephen Y. Lai
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
- Division of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - C. David Fuller
- Division of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Katherine A. Hutcheson
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
- Division of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Benjamin Sanchez
- Department of Electrical and Computer Engineering, The University of Utah, Salt Lake City, Utah, USA
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Tienkamp TB, Rebernik T, Halpern BM, van Son RJJH, Wieling M, Witjes MJH, de Visscher SAHJ, Abur D. Quantifying Articulatory Working Space in Individuals Surgically Treated for Oral Cancer With Electromagnetic Articulography. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:384-399. [PMID: 38289853 DOI: 10.1044/2023_jslhr-23-00111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
PURPOSE The purpose of this study was to quantify sentence-level articulatory kinematics in individuals treated for oral squamous cell carcinoma (ITOC) compared to control speakers while also assessing the effect of treatment site (jaw vs. tongue). Furthermore, this study aimed to assess the relation between articulatory-kinematic measures and self-reported speech problems. METHOD Articulatory-kinematic data from the tongue tip, tongue back, and jaw were collected using electromagnetic articulography in nine Dutch ITOC and eight control speakers. To quantify articulatory kinematics, the two-dimensional articulatory working space (AWS; in mm2), one-dimensional anteroposterior range of motion (AP-ROM; in mm), and superior-inferior range of motion (SI-ROM in mm) were calculated and examined. Self-reported speech problems were assessed with the Speech Handicap Index (SHI). RESULTS Compared to a sex-matched control group, ITOC showed significantly smaller AWS, AP-ROM, and SI-ROM for both the tongue tip and tongue back sensor, but no significant differences were observed for the jaw sensor. This pattern was found for both individuals treated for tongue and jaw tumors. Moderate nonsignificant correlations were found between the SHI and the AWS of the tongue back and jaw sensors. CONCLUSIONS Despite large individual variation, ITOC showed reduced one- and two-dimensional tongue, but not jaw, movements compared to control speakers and treatment for tongue and jaw tumors resulted in smaller tongue movements. A larger sample size is needed to establish a more generalizable connection between the AWS and the SHI. Further research should explore how these kinematic changes in ITOC are related to acoustic and perceptual measures of speech.
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Affiliation(s)
- Thomas B Tienkamp
- Center for Language and Cognition Groningen, University of Groningen, the Netherlands
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, the Netherlands
- Research School of Behavioral and Cognitive Neurosciences, University of Groningen, the Netherlands
| | - Teja Rebernik
- Center for Language and Cognition Groningen, University of Groningen, the Netherlands
- Research School of Behavioral and Cognitive Neurosciences, University of Groningen, the Netherlands
- Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Bence M Halpern
- Netherlands Cancer Institute, Amsterdam, the Netherlands
- Amsterdam Center for Language and Communication, University of Amsterdam, the Netherlands
- Multimedia Computing Group, Delft University of Technology, the Netherlands
| | - Rob J J H van Son
- Netherlands Cancer Institute, Amsterdam, the Netherlands
- Amsterdam Center for Language and Communication, University of Amsterdam, the Netherlands
| | - Martijn Wieling
- Center for Language and Cognition Groningen, University of Groningen, the Netherlands
- Research School of Behavioral and Cognitive Neurosciences, University of Groningen, the Netherlands
- Haskins Laboratories, New Haven, CT
| | - Max J H Witjes
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, the Netherlands
| | | | - Defne Abur
- Center for Language and Cognition Groningen, University of Groningen, the Netherlands
- Research School of Behavioral and Cognitive Neurosciences, University of Groningen, the Netherlands
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Cortina LE, Meyer CD, Feng AL, Lin DT, Deschler DG, Richmon JD, Varvares MA. Depth of resection predicts loss of tongue tip sensation after partial glossectomy in oral tongue cancer: A pilot study. Oral Oncol 2023; 147:106595. [PMID: 37837737 DOI: 10.1016/j.oraloncology.2023.106595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/06/2023] [Accepted: 10/10/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE(S) To characterize the change in sensory function following partial glossectomy for oral tongue cancer (OTC) and to identify predictors of loss of tongue-tip sensation (LoTTS). MATERIALS AND METHODS Patients with at least three months follow-up after partial glossectomy for primary OTC were included. All patients underwent a qualitative tongue sensation assessment and an objective tongue sensory exam of the native tongue tip. Additional details regarding the oncologic resection, surgical reconstruction, and pathological stage were collected. Multiple linear and logistic regressions were used for statistical analysis. RESULTS Sixty-four patients were enrolled, including 34 (53%) men with a median age of 65 at enrollment. Ten (15%) patients reported LoTTS. Increased depth of resection (DOR) was an independent predictor of LoTTS on multivariate analysis, with an increased risk at a threshold of 1.3 cm. LoTTS was also associated with worse subjective quality of life and perceptive speech performance in our qualitative tongue assessment. CONCLUSIONS In this pilot study, we found that DOR is a critical prognostic factor in predicting post treatment function. Patients with an increased DOR, particularly above 1.3 cm, are at greatest risk of LoTTS and associated morbidity. These findings may be used to predict post-operative sensory deficits, manage patients' expectations, and optimize the reconstructive approach. Future studies are needed to validate and replicate our results.
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Affiliation(s)
- Luis E Cortina
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States
| | - Charles D Meyer
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States
| | - Allen L Feng
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States
| | - Derrick T Lin
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States
| | - Daniel G Deschler
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States
| | - Jeremy D Richmon
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States
| | - Mark A Varvares
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States.
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Graboyes EM, Barbon CEA. Optimizing Function and Appearance After Head and Neck Reconstruction: Measurement and Intervention. Otolaryngol Clin North Am 2023; 56:835-852. [PMID: 37246027 PMCID: PMC10330938 DOI: 10.1016/j.otc.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Approximately 50% of head and neck cancer (HNC) survivors are left with dysphagia as a result of treatment sequele, and 25% of survivors experience clinically significant body image distress (BID). Both dysphagia and BID adversely affect quality of life and should be tracked using validated clinician- and patient-reported outcome measures such as the Performance Status Scale for Head and Neck Cancer, MD Anderson Dysphagia Inventory, and Inventory to Measure and Assess imaGe disturbancE-Head & Neck (IMAGE-HN). Subjective and objective evaluation measures are critical to dysphagia workup and management. Building a renewed image after head and neck cancer treatment, a brief telemedicine-based cognitive behavioral therapy, has become the first evidence-based treatment for BID among HNC survivors.
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Affiliation(s)
- Evan M Graboyes
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425, USA; Department of Public Health Sciences, Medical University of South Carolina
| | - Carly E A Barbon
- Department of Head & Neck Surgery, University of Texas MD Anderson Cancer Center, Unit 1445, 1515 Holcombe Boulevard, Houston, TX 77030-400, USA.
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Chepeha DB, Esemezie AO, Philteos J, Brown DH, de Almeida JR, Gilbert RW, Goldstein DP, Gullane PJ, Irish JC, Yao CM, Barbon CEA. Glossectomy for the treatment of oral cavity carcinoma: Quantitative, functional and patient-reported quality of life outcomes differ by four glossectomy defects. Oral Oncol 2023; 142:106431. [PMID: 37263070 DOI: 10.1016/j.oraloncology.2023.106431] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The goal was to characterize four clinically distinct glossectomy defects to establish significant quantitative cut points using functional metrics, the MD Anderson Dysphagia Index (MDADI) and speech intelligibility. METHODS Population included 101 patients treated with surgery, adjuvant radiation per NCCN guidelines, and ≥ 12 months follow-up. RESULTS Defect groups: subtotal hemiglossectomy (1), hemiglossectomy (2), extended hemiglossectomy (3) and oral glossectomy (4) were compared: All outcomes supported a four defect model. Intergroup comparison of outcomes with subtotal hemiglossectomy as reference (p value): Tongue Protrusion <0.001,<0.001,<0.001; Elevation <0.001,<0.001,<0.001; Open Mouth Premaxillary Contact Elevation <0.001,<0.001,<0.001; Obliteration 0.6,<0.001,<0.001; Normalcy of Diet, <0.3,<0.001,<0.001; Nutritional Mode, <0.9,<0.8,<0.001; Range of Liquids, <0.4,<0.016,<0.02; Range of Solids, <0.5,<0.004,<0.001; Eating in Public, <0.2,<0.002,<0.03; Understandability of Speech, <0.9,<0.001,<0.001; Speaking in Public, <0.4,<0.03,<0.001; MDADI, <0.4,<0.005,<0.01; Single Word Intelligibility, <0.4,<0.1,<0.001; Sentence Intelligibility, <0.5,<0.08,<0.001; Words Per Minute Intelligibility, <0.6,<0.04,<0.001; Sentence Efficiency Ratio, <0.4,<0.03,<0.002. Proportion of patients by 4 defect groups who underwent: tissue transplantation, 51%,93.9%,100%,100%.Radiation,24%,67%,88%,80%.Between hemiglossectomy and extended hemiglossectomy, the defect extends into the contralateral floor of the mouth and/or the anterior tonsillar pillar; resection of these subunits limits tongue mobility with an impact on functional outcome and MDADI. Between extended hemiglossectomy and oral glossectomy, the defect extends to include the tip of the tongue and appears to impact functional outcome and MDADI. CONCLUSIONS Subtotal hemiglossectomy, hemiglossectomy, extended glossectomy and oral glossectomy are associated with quantitative (elevation, protrusion, open mouth premaxillary contact and obliteration), qualitative (speech and swallowing) and MDADI differences, suggesting that these 4 ordinal defect groups are distinct.
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Affiliation(s)
- Douglas B Chepeha
- Department of Otolaryngology-Head & Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada; Department of Otolaryngology-Head & Neck Surgery, University of Michigan Health System, Ann Arbor, MI, United States.
| | - Alex O Esemezie
- Department of Otolaryngology-Head & Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Justine Philteos
- Department of Otolaryngology-Head & Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Dale H Brown
- Department of Otolaryngology-Head & Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - John R de Almeida
- Department of Otolaryngology-Head & Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Ralph W Gilbert
- Department of Otolaryngology-Head & Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - David P Goldstein
- Department of Otolaryngology-Head & Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Patrick J Gullane
- Department of Otolaryngology-Head & Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Jonathan C Irish
- Department of Otolaryngology-Head & Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Christopher Mkl Yao
- Department of Otolaryngology-Head & Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Carly E A Barbon
- Department of Head & Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Stephen SE, Murphy JM, Beyer FR, Sellstrom D, Paleri V, Patterson JM. Early postoperative functional outcomes following transoral surgery for oropharyngeal cancer: A systematic review. Head Neck 2021; 44:530-547. [PMID: 34882886 DOI: 10.1002/hed.26938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 11/02/2021] [Accepted: 11/08/2021] [Indexed: 11/11/2022] Open
Abstract
There has been increased interest in the use of transoral surgery (TOS) for the treatment of oropharyngeal cancer (OPC). This systematic review summarizes the available evidence for validated functional outcomes following TOS for OPC, within the early postoperative period. Key databases were searched. Primary TOS resections of human subjects were included. Validated functional outcomes extracted included instrumental assessment, clinician rated, and patient reported measures. Database searches yielded 7186 titles between 1990 and December 2020. Full-text articles were obtained for 296 eligible studies, which were screened and a resulting 14 studies, comprising 665 participants were included in the review. Oropharyngeal dysfunction following TOS was observed across all three categories of outcome measures (OMs) reported and was dependent on pretreatment function, T-classification, and tumor volume. Future investigations should include optimal OMs to be used in the postoperative setting to allow for conclusive comparisons.
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Affiliation(s)
- Sarah E Stephen
- Speech, Voice and Swallow Department, Freeman Hospital, Newcastle upon Tyne, UK
| | - Jennifer M Murphy
- Speech, Voice and Swallow Department, Freeman Hospital, Newcastle upon Tyne, UK
| | - Fiona R Beyer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Diane Sellstrom
- Speech, Voice and Swallow Department, Freeman Hospital, Newcastle upon Tyne, UK
| | - Vinidh Paleri
- Head and Neck Unit, Royal Marsden Hospital, London, UK
| | - Joanne M Patterson
- School of Health Sciences, Liverpool Head and Neck Cancer Centre, University of Liverpool, Liverpool, UK
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Cuellar ME, Oommen E. Objective physiological measures of lingual and jaw function in healthy individuals and individuals with dysphagia due to neurodegenerative diseases. MethodsX 2021; 8:101461. [PMID: 34430339 PMCID: PMC8374632 DOI: 10.1016/j.mex.2021.101461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/17/2021] [Indexed: 11/24/2022] Open
Abstract
Swallowing is a neuromuscular process that involves a complex sequence of sensorimotor events, which are executed to efficiently and safely transport food and liquid from the mouth to the stomach. Safe oropharyngeal swallowing involves the activation, modulation, and coordination of oral, pharyngeal, laryngeal, and esophageal structures and musculature. Impaired or atypical patterns of swallowing are considered characteristic of a swallowing disorder, otherwise referred to as dysphagia, and affect the performance of all stages, i.e., oral preparatory, oral transit, pharyngeal, and esophageal. Lingual and jaw musculature play critical roles in mediating swallowing function, particularly during the oral preparatory and oral transit stages. This current study presents an adapted simple, economical, and clinically relevant protocol that may be used to quantify lingual and jaw movement in healthy and disordered swallowing, and thus track physiological changes in lingual and jaw musculature over time in individuals with dysphagia due to neurodegenerative diseases.Jaw ROM tasks, adapted from [1,2], were adapted and utilized to measure the jaw during three postures: opening, lateralization, and protrusion. Adapting a scale developed by Lazarus and colleagues [3], objective lingual ROM values were obtained using the TheraBiteⓇ tool [4] and categorized according to functional status. Upon methodological adaption and collation of lingual ROM and jaw ROM tasks, a comprehensive set of images clearly depicting each procedural task and a clinically friendly form were developed to guide data collection for research and clinical use.
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Hutcheson K, McMillan H, Warneke C, Porsche C, Savage K, Buoy S, Wang J, Woodman K, Lai S, Fuller C. Manual Therapy for Fibrosis-Related Late Effect Dysphagia in head and neck cancer survivors: the pilot MANTLE trial. BMJ Open 2021; 11:e047830. [PMID: 34348950 PMCID: PMC8340274 DOI: 10.1136/bmjopen-2020-047830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Late dysphagia that develops or persists years after head and neck cancer (HNC) is a disabling survivorship issue. Fibrosis is thought to stiffen connective tissues and compress peripheral nerve tracts, thereby contributing to diminished strength, flexibility, and in some cases denervation of swallowing muscles. Manual therapy (MT) is used in cancer survivors for pain and other indications, but it is unknown if increasing blood flow, flexibility and cervical range of motion (CROM) in the head and neck may improve late dysphagia. METHODS AND ANALYSIS Manual Therapy for Fibrosis-Related Late Effect Dysphagia (MANTLE) is a National Cancer Institute-funded prospective single-arm pilot trial evaluating the feasibility, safety and therapeutic potential of MT in patients with late dysphagia after radiotherapy (RT) for HNC. Disease-free survivors ≥2 years after curative-intent RT for HNC with at least moderate dysphagia and grade ≥2 Common Terminology Criteria for Adverse Events version 4.0 fibrosis are eligible. The target sample size is 24 participants who begin the MANTLE programme. MANTLE is delivered in 10 MT sessions over 6 weeks with an accompanying home exercise programme (HEP). Patients then transition to a 6-week post-washout period during which they complete the HEP and then return for a final post-washout evaluation. Feasibility (primary endpoint) and safety will be examined. Serial assessments include CROM, modified barium swallow studies, quantitative MRI, electromyography (optional) and patient-reported outcomes as secondary, tertiary and exploratory endpoints. ETHICS AND DISSEMINATION The research protocol and informed consent document was approved by the Institutional Review Board at the University of Texas MD Anderson Cancer Center. Findings will be disseminated through peer-reviewed publication that will be made publicly available on PubMed Central on acceptance for publication, in compliance with NIH public access policy. TRIAL REGISTRATION NUMBER NCT03612531.
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Affiliation(s)
- Katherine Hutcheson
- Head and Neck Surgery, Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Holly McMillan
- Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carla Warneke
- Biostatics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Christine Porsche
- Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kiara Savage
- Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sheila Buoy
- Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jihong Wang
- Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Karin Woodman
- Neurology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Stephen Lai
- Head and Neck Surgery, Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Clifton Fuller
- Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Pai P, Tuljapurkar V, Balaji A, Mishra A, Chopda P, Agarwal S, Bachher GK. Comparative study of functional outcomes following surgical treatment of early tongue cancer. Head Neck 2021; 43:3142-3152. [PMID: 34302408 DOI: 10.1002/hed.26811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/01/2021] [Accepted: 07/08/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Speech and swallowing are important outcomes following resection in early tongue cancers. AIM This prospective study was performed to compare speech, swallowing, and tongue mobility between secondary intention healing (SH) and primary closure (PC) in glossectomy for early tongue cancers. METHODS Forty T1/T2 tongue cancers underwent wide excision followed by either PC or SH. Operative time, tube feeding, complications, speech, and swallowing were assessed in both groups at 1, 6, 12, and 24 weeks after surgery. RESULTS SH showed better tongue mobility, less errors in continuous speech, and articulation as compared to PC at all-time points. Operative time, bleeding, duration of tube feeding, and pain scores were comparable in both groups. There were no major complications except minor secondary hemorrhage in one patient with SH. CONCLUSION Following early tongue cancer resection, secondary intention healing can result in better speech and tongue mobility with minimum morbidity.
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Affiliation(s)
- Prathamesh Pai
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Vidisha Tuljapurkar
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Arun Balaji
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Aseem Mishra
- Department of Head and Neck Surgical Oncology, MPMMM Cancer Centre, Homi Bhabha National Institute, Varanasi, India
| | - Prashant Chopda
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Swapnil Agarwal
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Gurmeet Kaur Bachher
- Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
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Bulbul MG, Wu M, Lin D, Emerick K, Deschler D, Richmon J, Goldsmith T, Zenga J, Puram SV, Varvares MA. Prediction of Speech, Swallowing, and Quality of Life in Oral Cavity Cancer Patients: A Pilot Study. Laryngoscope 2021; 131:2497-2504. [PMID: 33881173 DOI: 10.1002/lary.29573] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/09/2021] [Accepted: 04/09/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS To investigate the impact of specific treatment-related variables on functional and quality of life outcomes in oral cavity cancer (OCC) patients. STUDY DESIGN Retrospective Cohort. METHODS Patients with primary OCC at least 6 months after resection and adjuvant therapy were included. Patients completed surveys including the Speech Handicap Index (SHI), M.D. Anderson Dysphagia Inventory (MDADI), and Functional Assessment of Cancer Therapy-Head and Neck (FACT-HN). Performance Status Scale (PSS) and tongue mobility scale were completed to allow provider-rated assessment of speech and tongue mobility, respectively. Additional details regarding treatment were also collected. These data were used to generate a predictive model using linear regression. RESULTS Fifty-three patients with oral tongue and/or floor of mouth (FOM) resection were included in our study. In multivariable analysis, greater postoperative tongue range of motion (ROM) and time since treatment improved SHI. Flap reconstruction and greater postoperative tongue ROM increased MDADI and PSS (eating and speech). A larger volume of resected tissue was inversely correlated with PSS (diet and speech). Tumor site was an important predictor of PSS (all sections). There were no statistically significant predictors of FACT-HN. CONCLUSIONS In this pilot study, we propose a battery of tools to assess function in OCC patients treated with surgery. Using the battery of tools we propose, our results show that a surgical endpoint that preserves tongue mobility and employs flap reconstruction resulted in better outcomes, whereas those with greater volume of tissue resected and FOM involvement resulted in poorer outcomes. Larger prospective studies are needed to validate our findings. LEVEL OF EVIDENCE 3 Laryngoscope, 2021.
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Affiliation(s)
- Mustafa G Bulbul
- Department of Otolaryngology, Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, U.S.A
| | - Michael Wu
- Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Derrick Lin
- Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Kevin Emerick
- Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Daniel Deschler
- Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Jeremy Richmon
- Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Tessa Goldsmith
- Department of Speech, language and swallowing disorders, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Joseph Zenga
- Department of Otolaryngology, Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Sidharth V Puram
- Department of Otolaryngology, Head and Neck Surgery Washington University in St Louis, St Louis, Missouri, U.S.A
| | - Mark A Varvares
- Department of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A
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Oommen ER, Cuellar ME, Scholten A, Rylander B, David M. Objective measures of lingual and jaw function in healthy adults and persons with Parkinson's disease: Implications for swallowing. Physiol Behav 2021; 232:113349. [PMID: 33545210 DOI: 10.1016/j.physbeh.2021.113349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 12/13/2022]
Abstract
The study examines the effects of age and Parkinson's disease on lingual and jaw function in neurotypical adults, as well as persons with Parkinson's Disease. Preliminary results provide reference measures in these populations and support the systematic collection of objective data regarding lingual strength, lingual range of motion, and jaw range of motion in clinical populations. The application of this clinically meaningful protocol also provides a means to track physiological changes over time in order to maximize the results of rehabilitative efforts to restore swallow function.
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Affiliation(s)
- Elizabeth R Oommen
- Calvin University, Speech Pathology and Audiology Department, 1810 E. Beltline Ave SE, Grand Rapids, MI 49546, United States
| | - Megan E Cuellar
- San José State University, Communicative Disorders & Sciences, One Washington Square, San Jose, CA 95192-0046, United States.
| | - Alyssa Scholten
- Helen DeVos Children's Hospital, 100 Michigan St NE, Grand Rapids, MI 49503, United States
| | - Bethany Rylander
- Colt Early Childhood Center, 4344 W. Michigan Ave, Lansing, MI 48917, United States
| | - Mallika David
- Metro Health, Univ of Michigan, 5900 Byron Center Ave, Wyoming, MI 49519, United States
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12
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Kappert KDR, van Dijk S, Wellenstein D, van Alphen MJA, van Son RJJH, Smeele LE, Balm AJM. Five Specific Tongue Movements in a Healthy Population. Dysphagia 2020; 36:736-742. [PMID: 33040201 PMCID: PMC8289788 DOI: 10.1007/s00455-020-10195-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 09/28/2020] [Indexed: 11/29/2022]
Abstract
The importance of tongue mobility on speech, oral food transport, and swallowing is well recognized. However, whether the individual tongue mobility influences postoperative function in oral cancer treatment remains to be elucidated. This study assesses the ability to perform five tongue movements as rolling, twisting (two sides), folding, and the 'cloverleaf' in a healthy population. Because a tumor in oral cancer patients often restricts the mobility of the tongue, it might be helpful to know if it is possible to recall any of those movements without demonstrating it. Two observers asked 387 Dutch healthy adults if they could perform one of the five specific tongue movements and were subsequently asked to demonstrate the five movements. The distribution in the Dutch population is: rolling: 83.7%, cloverleaf: 14.7%, folding: 27.5%, twisting left: 36.1% and twisting right: 35.6%. The percentage of people that can fold their tongue is almost ten times higher (3% versus 27.5%) than in previous research, and it was found that the ability to roll the tongue is not a prerequisite for folding of the tongue. A relationship between gender or right-handedness and the ability to perform certain tongue movements could not be found. Of the participants, 9.9% and 13.1% incorrectly assumed that they could demonstrate tongue rolling and cloverleaf. Tongue folding and twisting (left or right) were incorrectly assumed in 36.9%, 24.1%, and 25.4% of the cases. Rolling and cloverleaf are preferred for future prediction models because these movements are easy to recall without demonstrating.
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Affiliation(s)
- Kilian D R Kappert
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. .,Robotics and Mechatronics, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
| | - Simone van Dijk
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - David Wellenstein
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Maarten J A van Alphen
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Rob J J H van Son
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Amsterdam Center for Language and Communication, Universtiy of Amsterdam, Amsterdam, The Netherlands
| | - Ludi E Smeele
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Alfons J M Balm
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands
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13
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Development of a clinical scale for assessment of patients with diffuse intrinsic pontine glioma (DIPG) receiving experimental therapy: the PONScore. J Neurooncol 2020; 149:263-272. [PMID: 32902768 DOI: 10.1007/s11060-020-03594-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/08/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Monitoring neurological side-effects in experimental therapy for diffuse intrinsic pontine glioma (DIPG) can be challenging. We aimed to develop a neurological scale that could be used by non-specialists to quantify neurological changes during experimental treatment of DIPG. METHODS We developed the Pontine Observational Neurological Score (PONScore) to measure signs and symptoms of DIPG by adapting validated assessment scales of neurological signs and symptoms in children. We developed a prototype score, taught it to paediatric intensive care nursing staff, who used the Score to assess children receiving awake pontine infusion of chemotherapy for treatment of DIPG. We used their feedback to develop the PONScore. Points are allocated for headache, ophthalmoplegia, facial and tongue weakness, dysarthria, paraesthesia, limb weakness and dysmetria with increasing scores reflecting increasing disability. The PONScore was administered every hour during awake pontine infusion. Correlation and agreement calculations between nursing staff, as non-specialists, and a specialist rater were performed in 30 infusions in 6 children (aged 8-11). Changes in PONScore versus volume of infusion are described in a further 55 infusions in 8 children (aged 3-11). RESULTS The PONScore demonstrated excellent intra-rater reliability with an intra-class co-efficient of 0.98 (95% CI 0.97-0.99; p-value < 0.001) between a specialist and non-specialist raters with strong correlation between scores and a Spearman correlation coefficient of 0.985 (p < 0.001). PONScores increased from 3.3 to 5.7 (p-value < 0.001) during infusion reflecting accumulation of neurological signs and symptoms during infusion. CONCLUSIONS We describe a novel neurological scale that can be used by non-specialists to describe acute neurological changes in children receiving experimental therapy for DIPG. Prospective validation as part of a clinical trial is required.
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14
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Kappert KDR, van Alphen MJA, Smeele LE, Balm AJM, van der Heijden F. Quantification of tongue mobility impairment using optical tracking in patients after receiving primary surgery or chemoradiation. PLoS One 2019; 14:e0221593. [PMID: 31454385 PMCID: PMC6711543 DOI: 10.1371/journal.pone.0221593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 08/10/2019] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Tongue mobility has shown to be a clinically interesting parameter on functional results after tongue cancer treatment which can be objectified by measuring the Range Of Motion (ROM). Reliable measurements of ROM would enable us to quantify the severity of functional impairments and use these for shared decision making in treatment choices, rehabilitation of speech and swallowing disturbances after treatment. METHOD Nineteen healthy participants, eighteen post-chemotherapy patients and seventeen post-surgery patients were asked to perform standardized tongue maneuvers in front of a 3D camera system, which were subsequently tracked and corrected for head and jaw motion. Indicators, such as the left-right tongue range and the deflection angle with the horizontal axis were extracted from the tongue trajectory to serve as a quantitative measure for the impaired tongue mobility. RESULTS The range and deflection angle showed an excellent intra- and interrater reliability (ICC 0.9) The repeatability experiment showed an average standard deviation of 2.5 mm to 3.5 mm for every movement, except the upward movement. The post-surgery patient group showed a smaller tongue range and higher deflection angle overall than the healthy participants. Post-chemoradiation patients showed less difference in tongue ROM compared with healthy participants. Only a few patients showed asymmetrical movement after treatment, which could not always be explained by T-stage or the side of treatment alone. CONCLUSION We introduced a reliable and reproducible method for measuring the ROM and to quantify for motion impairments, that was able to show differences in tongue ROM between healthy subjects and patients after chemoradiation or surgery. Future research should focus on measuring patients with oral cancer pre- and post-treatment in combination with the collection of detailed information about the individual tongue anatomy, so that the full ROM trajectory can be used to identify changes over time and to quantify functional impairment.
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Affiliation(s)
- K. D. R. Kappert
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Robotics and Mechatronics, University of Twente, Enschede, The Netherlands
- * E-mail:
| | - M. J. A. van Alphen
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - L. E. Smeele
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - A. J. M. Balm
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Robotics and Mechatronics, University of Twente, Enschede, The Netherlands
- Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - F. van der Heijden
- Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Robotics and Mechatronics, University of Twente, Enschede, The Netherlands
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15
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Hwang NK, Kim HH, Shim JM, Park JS. Tongue stretching exercises improve tongue motility and oromotor function in patients with dysphagia after stroke: A preliminary randomized controlled trial. Arch Oral Biol 2019; 108:104521. [PMID: 31476522 DOI: 10.1016/j.archoralbio.2019.104521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/03/2019] [Accepted: 08/10/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study investigated the effect of tongue stretching exercises (TSE) on tongue motility and oromotor function in patients with dysphagia after stroke. DESIGN This study was designed as a 4-week, double-blind, two-group, block randomized controlled trial. A total of 25 patients were randomly allocated into either the experimental (n = 13) or the control group (n = 12). The experimental group received TSE from an occupational therapist. TSE were divided into dynamic and static passive stretching exercises (20 repetitions each). The intervention was performed five times a week for four weeks. Tongue motility was measured before and after the intervention as the distance from the lower lip to the tip of tongue during maximum protrusion of the tongue. Measurements were performed twice each time and the mean value recorded. Oromotor function was assessed using the oral phase events of the videofluoroscopic dysphagia scale (VDS) based on a videofluoroscopic swallowing study. RESULTS The experimental group showed significant differences in tongue motility, bolus formation, tongue to palate contact, premature bolus loss, and oral transit time in the oral phase of VDS (p < 0.05 for all) before and after the intervention, whereas the control group showed a significant difference only in lip closure (p < 0.05). CONCLUSION This study demonstrated that TSE have a positive effect on tongue motility and oromotor function in patients with dysphagia after stroke. Therefore, we recommend TSE as an effective treatment for dysphagia.
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Affiliation(s)
- Na-Kyoung Hwang
- Department of Occupational Therapy, Seoul North Municipal Hospital, Seoul, Republic of Korea
| | - Hwan-Hee Kim
- Department of Occupational Therapy, Semyung University, Jecheon, Republic of Korea
| | - Je-Myung Shim
- Department of Physical Therapy, Kangwon National University, Samcheok, Republic of Korea
| | - Ji-Su Park
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, Busan, Republic of Korea.
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16
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Lazarus CL, Ganz C, Ru M, Miles BA, Kotz T, Chai RL. Prospective instrumental evaluation of swallowing, tongue function, and QOL measures following transoral robotic surgery alone without adjuvant therapy. Head Neck 2018; 41:322-328. [DOI: 10.1002/hed.25455] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/05/2018] [Accepted: 08/15/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Cathy L. Lazarus
- THANC Foundation New York New York
- Departments of Otolaryngology‐Head & Neck Surgery, Mount Sinai Health System New York New York
| | - Cindy Ganz
- THANC Foundation New York New York
- Departments of Otolaryngology‐Head & Neck Surgery, Mount Sinai Health System New York New York
| | - Meng Ru
- Population Health Science & PolicyIcahn School of Medicine at Mount Sinai New York New York
| | - Brett A. Miles
- Departments of Otolaryngology‐Head & Neck Surgery, Mount Sinai Health System New York New York
| | - Tamar Kotz
- Departments of Otolaryngology‐Head & Neck Surgery, Mount Sinai Health System New York New York
| | - Raymond L. Chai
- THANC Foundation New York New York
- Departments of Otolaryngology‐Head & Neck Surgery, Mount Sinai Health System New York New York
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17
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Likhterov I, Ru M, Ganz C, Urken ML, Chai R, Okay D, Liu J, Stewart R, Culliney B, Palacios D, Lazarus CL. Objective and subjective hyposalivation after treatment for head and neck cancer: Long-term outcomes. Laryngoscope 2018; 128:2732-2739. [PMID: 30325025 DOI: 10.1002/lary.27224] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study examined saliva weight over time and its association with diet and patient-rated swallowing, dry mouth, sticky saliva, and dysgeusia quality of life in head and neck cancer (HNCA) patients treated with surgery plus adjuvant chemoradiotherapy (CRT), or primary CRT. STUDY DESIGN Prospective cohort study in an outpatient HNCA center setting. METHODS Patients were seen pretreatment, and 1, 3, 6, 12, 24, and 36 + months post-treatment. All had newly diagnosed oral, oropharynx, nasopharynx, larynx/hypopharynx cancer from 2010 to 2016 and were to undergo surgery + CRT or primary CRT. Stimulated saliva weight was assessed with the Saxon test. Diet, eating, dry mouth, and dysgeusia quality of life were assessed and correlated with saliva weight, treatment modality, and tumor site. RESULTS Saliva weight decreased the most within the first 3 months across treatment groups, except for the surgery + CRT group, which continued to decline. Similar trends were seen by tumor site. Performance Status Scale (PSS) Normalcy of Diet and all quality-of-life scores declined following treatment. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck-35 (EORTC QLQ-H&N35); Eating Assessment Tool (EAT-10); M. D. Anderson Dysphagia Inventory (MDADI) Composite, Global, and subdomain scores; and PSS Diet were significantly correlated with saliva weight. CONCLUSIONS Saliva weight worsened post-treatment across groups and tumor site, with improvement by 36 + months. Saliva weight correlated with diet, eating quality of life and perception of dysgeusia across time points. Despite dose-sparing intensity-modulated radiation therapy, newer technologies are needed to preserve saliva production and maintain higher quality of life. LEVEL OF EVIDENCE 2b Laryngoscope, 128:2732-2739, 2018.
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Affiliation(s)
- Ilya Likhterov
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Meng Ru
- Department of Population Health Science and Policy
| | - Cindy Ganz
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Mark L Urken
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Raymond Chai
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Devin Okay
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
| | - Jerry Liu
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York
| | - Robert Stewart
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York
| | - Bruce Culliney
- Department of Radiation Oncology.,Department of Medical Oncology, Mount Sinai Health System, New York, New York, U.S.A
| | - Daisy Palacios
- Department of Radiation Oncology.,Department of Medical Oncology, Mount Sinai Health System, New York, New York, U.S.A
| | - Cathy L Lazarus
- Thyroid, Head and Neck Cancer (THANC) Foundation, New York, New York.,Department of Otolaryngology-Head and Neck Surgery
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18
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Rodriguez AM, Komar A, Ringash J, Chan C, Davis AM, Jones J, Martino R, McEwen S. A scoping review of rehabilitation interventions for survivors of head and neck cancer. Disabil Rehabil 2018; 41:2093-2107. [DOI: 10.1080/09638288.2018.1459880] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Ana Maria Rodriguez
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Alyssa Komar
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jolie Ringash
- Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Catherine Chan
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Aileen M. Davis
- Division of Health Care and Outcomes, Krembil Research Institute, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Jennifer Jones
- Cancer Survivorship Program, University Health Network, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Rosemary Martino
- Speech-Language Pathology, University of Toronto, Toronto, Canada
| | - Sara McEwen
- St. John’s Rehab Research Program, Sunnybrook Research Institute, North York, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Canada
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19
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Kansy K, Hoffmann J, Bendszus M, Heiland S, Krisam J, Wohlfarth M, Mistele N, Geschwinder A, Gradl J. Tongue movement during articulation in magnetic resonance imaging: Findings in 20 healthy volunteers and a patient with anterior floor of the mouth squamous cell carcinoma. J Craniomaxillofac Surg 2017; 45:2046-2053. [PMID: 29037920 DOI: 10.1016/j.jcms.2017.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/27/2017] [Accepted: 09/11/2017] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Combined ablative and reconstructive oral maxillofacial surgery involves a multitude of anatomical and functional structures for speech and swallowing. Although there are a few methods to objectively examine swallowing function, this is not true for speech. We describe the development of an objective visualization and measurement tool for magnetic resonance imaging (MRI) to evaluate speech and its first application in a patient. MATERIAL AND METHODS A total of 20 healthy patients and one patient with squamous cell carcinoma localized in the anterior floor of the mouth were included in the study. Examination included an MRI examination of a paced, defined set of fictive words representing all sounds of the German language. The patient underwent MRI preoperatively and 1, 3, 6 and 12 months postoperatively. MRI findings were correlated with speech intelligibility. RESULTS In sagittal planes, the correct identification of vowels and consonants was feasible and showed a high accordance between two independent observers and repetitions. Measurements for the patient showed significant deviations 1 month postoperatively but gradually decreased over time. Aberrant values were persistent for sound /s/. Findings correlated with clinical findings of speech intelligibility. CONCLUSION The presented tool seems to be promising for evaluating articulation in (tumor) patients.
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Affiliation(s)
- Katinka Kansy
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Johannes Krisam
- Institute of Medical Biometry and Informatics, Department Medical Biometry, University of Heidelberg, Heidelberg, Germany
| | - Matthias Wohlfarth
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Nicole Mistele
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Anne Geschwinder
- Department of Otorhinolaryngology and Phoniatrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Johann Gradl
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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20
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Kim WJ, Choi JB, Park JS, Lee SH. The effects of tongue stretching exercise on tongue length in healthy adults: a preliminary study. J Phys Ther Sci 2017; 29:1929-1930. [PMID: 29200626 PMCID: PMC5702816 DOI: 10.1589/jpts.29.1929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 08/08/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the effects of tongue stretching
exercise on the tongue length of healthy adults. [Subjects and Methods] This study
recruited 6 healthy adults. They were treated for 4 weeks with tongue stretching. The
change in tongue length during tongue protrusion before and after intervention was
measured using a ruler. [Results] All 6 participants showed increased tongue length
(minimum 20 mm to maximum 40 mm). [Conclusion] This study confirms that tongue stretching
is a useful method to increase tongue length.
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Affiliation(s)
- Won-Jin Kim
- Department of Occupational Therapy, Kosin University, Republic of Korea
| | - Jong-Bae Choi
- Department of Occupational Therapy, KyungHee Medical Center, Republic of Korea
| | - Ji-Su Park
- Department of Rehabilitation Science, Graduate School of Inje University: 110 Inje-ro, Inje-eup, Inje-gun, Gangwon-do, Republic of Korea
| | - Sang-Hoon Lee
- Department of Rehabilitation Science, Graduate School of Inje University: 110 Inje-ro, Inje-eup, Inje-gun, Gangwon-do, Republic of Korea
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21
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van Dijk S, van Alphen MJA, Jacobi I, Smeele LE, van der Heijden F, Balm AJM. A New Accurate 3D Measurement Tool to Assess the Range of Motion of the Tongue in Oral Cancer Patients: A Standardized Model. Dysphagia 2015; 31:97-103. [DOI: 10.1007/s00455-015-9665-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 10/19/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Simone van Dijk
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. .,Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands.
| | - Maarten J A van Alphen
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Irene Jacobi
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Ludwig E Smeele
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Ferdinand van der Heijden
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Alfons J M Balm
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands
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