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Takatsu J, Higaki E, Abe T, Fujieda H, Yoshida M, Yamamoto M, Shimizu Y. Critical swallowing functions contributing to dysphagia in patients with recurrent laryngeal nerve paralysis after esophagectomy. Esophagus 2024; 21:111-119. [PMID: 38294588 DOI: 10.1007/s10388-023-01041-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Recurrent laryngeal nerve paralysis (RLNP) after esophagectomy can cause aspiration because of incomplete glottis closure, leading to pneumonia. However, patients with RLNP often have preserved swallowing function. This study investigated factors that determine swallowing function in patients with RLNP. METHODS Patients with esophageal cancer who underwent esophagectomy and cervical esophagogastric anastomosis were enrolled between 2017 and 2020. Videofluoroscopic examination of swallowing study (VFSS) and acoustic voice analysis were performed on patients with suspected dysphagia including RLNP. Dysphagia in VFSS was defined as score ≥ 3 of the 8-point penetration-aspiration scale VFSS and acoustic analysis results related to dysphagia were compared between patients with and without RLNP. RESULTS Among 312 patients who underwent esophagectomy, 74 developed RLNP. The incidence of late-onset pneumonia was significantly higher in the RLNP group than in the non-RLNP (18.9 vs. 8.0%, P = .008). Detailed swallowing function was assessed by VFSS in 84 patients, and patients with RLNP and dysphagia showed significantly shorter maximum diagonal hyoid bone elevation (10.62 vs. 16.75 mm; P = .003), which was a specific finding not seen in patients without RLNP. For acoustic voice analysis, the degree of hoarseness was not closely related to dysphagia. The length of oral intake rehabilitation for patients with and without RLNP was comparable if they did not present with dysphagia (8.5 vs. 9.0 days). CONCLUSIONS Impaired hyoid bone elevation is a specific dysphagia factor in patients with RLNP, suggesting compensatory epiglottis inversion by hyoid bone elevation is important for incomplete glottis closure caused by RLNP.
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Affiliation(s)
- Jun Takatsu
- Department of Rehabilitation, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
- Department of Speech Pathology, Aichi-Gakuin University, 12 Araike, Iwasaki-cho, Nisshin, Aichi, 470-0195, Japan.
| | - Eiji Higaki
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Tetsuya Abe
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Hironori Fujieda
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Masahiro Yoshida
- Department of Rehabilitation, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
- Department of Orthopedic Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Masahiko Yamamoto
- Department of Speech Pathology, Aichi-Gakuin University, 12 Araike, Iwasaki-cho, Nisshin, Aichi, 470-0195, Japan
| | - Yasuhiro Shimizu
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
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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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Tienkamp TB, van Son RJJH, Halpern BM. Objective speech outcomes after surgical treatment for oral cancer: An acoustic analysis of a spontaneous speech corpus containing 32.850 tokens. JOURNAL OF COMMUNICATION DISORDERS 2023; 101:106292. [PMID: 36521253 DOI: 10.1016/j.jcomdis.2022.106292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 11/21/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Surgical treatment for oral cancer leads to lasting changes of the vocal tract and individuals treated for oral cancer (ITOC) often experience speech problems. The purpose of this study was to analyse the acoustic properties of the spontaneous speech of individuals who were surgically treated for oral cancer. It was investigated (1) how key spectral measures of articulation change post-treatment; (2) whether changes are more related to target manner or place of articulation; and (3) how spectral measures develop at various time points following treatment. METHOD A corpus consisting of 32.850 tokens was constructed by manually segmenting the speech of five (four female - one male) American English speaking ITOC. General acoustic characteristics (duration and spectral tilt), plosives (burst frequency), fricatives (centre of gravity and spectral skewness), and vowels (F1 and F2) were analysed using linear mixed effects regression and compared to control speech. Moreover, a within speaker analysis was performed for speakers with multiple recordings. RESULTS Manner of articulation is more predictive of post-treatment changes than place of articulation. Compared to controls, ITOC produced the fricatives /f, v, θ, ð, s, z, ʃ, ʒ/ with a lower centre of gravity while no differences were found for plosives and vowels. Longitudinal analyses show high within-speaker variation, but general improvements one-year post-treatment. CONCLUSIONS Surgical oral cancer treatment changes the spectral properties of speech. Fricatives with varying manner of articulations were distorted, suggesting that manner of articulation is more predictive than place of articulation in identifying general problem areas for ITOC.
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Affiliation(s)
- Thomas B Tienkamp
- Center for Language and Cognition Groningen, University of Groningen, Oude Kijk in 't Jatstraat 26, 9712 EK, Groningen, The Netherlands.
| | - Rob J J H van Son
- Amsterdam Center for Language and Communication, University of Amsterdam, Spuistraat 134, 1012 VB Amsterdam, The Netherlands; Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Bence Mark Halpern
- Amsterdam Center for Language and Communication, University of Amsterdam, Spuistraat 134, 1012 VB Amsterdam, The Netherlands; Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands; Multimedia Computing Group, Delft University of Technology, Mekelweg 4, 2628 CD, Delft, The Netherlands
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Long-term functional outcomes and quality of life after partial glossectomy for T2 squamous cell carcinomas. Braz J Otorhinolaryngol 2022; 88 Suppl 4:S33-S43. [PMID: 34407916 DOI: 10.1016/j.bjorl.2021.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/09/2021] [Accepted: 06/28/2021] [Indexed: 12/14/2022] Open
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 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.
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Sleight A, Gerber LH, Marshall TF, Livinski A, Alfano CM, Harrington S, Flores AM, Virani A, Hu X, Mitchell SA, Varedi M, Eden M, Hayek S, Reigle B, Kerkman A, Neves R, Jablonoski K, Hacker ED, Sun V, Newman R, McDonnell KK, L'Hotta A, Schoenhals A, Dpt NLS. Systematic Review of Functional Outcomes in Cancer Rehabilitation. Arch Phys Med Rehabil 2022; 103:1807-1826. [PMID: 35104445 PMCID: PMC9339032 DOI: 10.1016/j.apmr.2022.01.142] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To systematically review the evidence regarding rehabilitation interventions targeting optimal physical or cognitive function in adults with a history of cancer and describe the breadth of evidence as well as strengths and limitations across a range of functional domains. DATA SOURCES PubMed, Cumulative Index to Nursing and Allied Health Plus, Scopus, Web of Science, and Embase. The time scope was January 2008 to April 2019. STUDY SELECTION Prospective, controlled trials including single- and multiarm cohorts investigating rehabilitative interventions for cancer survivors at any point in the continuum of care were included, if studies included a primary functional outcome measure. Secondary data analyses and pilot/feasibility studies were excluded. Full-text review identified 362 studies for inclusion. DATA EXTRACTION Extraction was performed by coauthor teams and quality and bias assessed using the American Academy of Neurology (AAN) Classification of Evidence Scheme (class I-IV). DATA SYNTHESIS Studies for which the functional primary endpoint achieved significance were categorized into 9 functional areas foundational to cancer rehabilitation: (1) quality of life (109 studies), (2) activities of daily living (61 studies), (3) fatigue (59 studies), (4) functional mobility (55 studies), (5) exercise behavior (37 studies), (6) cognition (20 studies), (7) communication (10 studies), (8) sexual function (6 studies), and (9) return to work (5 studies). Most studies were categorized as class III in quality/bias. Averaging results found within each of the functional domains, 71% of studies reported statistically significant results after cancer rehabilitation intervention(s) for at least 1 functional outcome. CONCLUSIONS These findings provide evidence supporting the efficacy of rehabilitative interventions for individuals with a cancer history. The findings should be balanced with the understanding that many studies had moderate risk of bias and/or limitations in study quality by AAN criteria. These results may provide a foundation for future work to establish clinical practice guidelines for rehabilitative interventions across cancer disease types.
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Affiliation(s)
- Alix Sleight
- Department of Physical Medicine and Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, California, United States; Center for Integrated Research in Cancer and Lifestyle (CIRCL), Cedars-Sinai Medical Center, Los Angeles, California, United States; Cedars Sinai Cancer, Los Angeles, California, United States; Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, United States.
| | - Lynn H Gerber
- College of Health and Human Services, George Mason University, Fairfax County, Virginia, United States; Inova Health System, Inova Medicine Services, Falls Church, Virginia, United States
| | | | - Alicia Livinski
- National Institutes of Health Library, Office of Research Services, National Institutes of Health, Bethesda, Maryland, United States
| | - Catherine M Alfano
- Northwell Health Cancer Institute, New Hyde Park, New York, United States; Center for Personalized Health, Feinstein Institutes for Medical Research, Manhasset, New York, United States; Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, United States
| | - Shana Harrington
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Ann Marie Flores
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States; Robert H. Lurie Comprehensive Cancer Center, Cancer Survivorship Institute, Chicago, Illinois, United States
| | - Aneesha Virani
- Rehabilitation Department, Northside Hospital, Atlanta, Georgia, United States
| | - Xiaorong Hu
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Boston, Massachusetts, United States; Rehabilitation Medicine School, Nanjing Medical University, Nanjing, China
| | - Sandra A Mitchell
- Outcomes Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, United States
| | - Mitra Varedi
- Epidemiology and Cancer Control Department, St Jude Children's Research Hospital, Memphis, Tennessee, United States
| | - Melissa Eden
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Scottsdale, Arizona, United States
| | - Samah Hayek
- Clalit Health Services, Clalit Research Institute, Ramat-Gan, Israel
| | - Beverly Reigle
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, United States
| | - Anya Kerkman
- Lincoln Cancer Rehabilitation, Lincoln, Nebraska, United States; CHI Health St Elizabeth, Lincoln, Nebraska, United States
| | - Raquel Neves
- Czech Rehabilitation Hospital, Al Ain, United Arab Emirates
| | - Kathleen Jablonoski
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; Department of Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Eileen Danaher Hacker
- Department of Science of Nursing Care, Indiana University School of Nursing, Indianapolis, Indiana, United States
| | - Virginia Sun
- Department of Population Sciences, City of Hope, Duarte, California, United States; Department of Surgery, City of Hope, Duarte, California, United States
| | - Robin Newman
- Department of Occupational Therapy, Boston University College of Health and Rehabilitation Sciences: Sargent College, Boston, Massachusetts, United States
| | - Karen Kane McDonnell
- College of Nursing, University of South Carolina, Columbia, South Carolina, United States
| | - Allison L'Hotta
- Department of Occupational Therapy, Washington University in St Louis, St Louis, Missouri, United States
| | - Alana Schoenhals
- Mrs T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, United States
| | - Nicole L Stout Dpt
- West Virginia University Cancer Institute, West Virginia University School of Public Health, Morgantown, West Virginia, United States; Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States
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Dasgupta S, Samuel S. Assessment of Speech in Patients Undergoing Hemiglossectomy with Primary Closure and Radiotherapy - A Prospective Study. Ann Maxillofac Surg 2022; 12:157-160. [PMID: 36874774 PMCID: PMC9976854 DOI: 10.4103/ams.ams_76_22] [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: 03/25/2022] [Revised: 08/29/2022] [Accepted: 09/06/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction The oral cavity plays a pivotal role in the generation of speech. The treatment of oral squamous cell carcinoma of the tongue requires an aggressive approach, combining resective surgery along with radiation therapy, with long-lasting effects on the patient's ability to speak. This study was designed to assess speech in subjects with carcinoma of the tongue following hemiglossectomy with primary closure and radiotherapy. Methods A prospective study was carried out in 20 subjects who underwent hemiglossectomy with primary closure for carcinoma of the tongue followed by radiotherapy. All subjects were evaluated for speech using 'Kannada Diagnostic Photo Articulation Test' before surgery, after surgery (on the 10th and 30th day), during radiation therapy after 15 fractions of radiation and after 1, 2 and 3 months following completion of radiotherapy. Statistical analysis was performed using SPSS software (v. 17.0). Significance levels were determined using ANOVA followed by Bonferroni correction. Results Intelligibility of speech was noted to be affected most at the one month follow-up visit after completion of radiotherapy (P < 0.001). The Kannada Diagnostic Photo Articulation Test proves to be a useful tool in assessing changes in speech, with results that can be replicated in further studies. Discussion The incidence of articulatory errors is increased following surgery and radiotherapy. Over time, the number of errors reduce and approach the baseline, indicating that although speech is indeed hampered by the treatment, with adequate speech therapy one can regain their preoperative articulation.
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Affiliation(s)
- Sohini Dasgupta
- Department of Oral and Maxillofacial Surgery, A B Shetty Memorial Institute of Dental Sciences (ABSMIDS), NITTE (Deemed to be University), Mangalore, Karnataka, India
| | - Soumi Samuel
- Department of Oral and Maxillofacial Surgery, A B Shetty Memorial Institute of Dental Sciences (ABSMIDS), NITTE (Deemed to be University), Mangalore, Karnataka, India
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Dhakad V, Saldanha E, Patel D, Desai S, Joseph B, Ghosh S, Monteiro A. Comparison of functional and survival outcomes in pedicled and microsurgical flap reconstruction for near-total and total glossectomies. Ann Maxillofac Surg 2022; 12:54-59. [PMID: 36199453 PMCID: PMC9527839 DOI: 10.4103/ams.ams_178_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 05/30/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: Patients with advanced carcinoma tongue end up with near-total/total glossectomy (NTG/TG). We intended to compare functional, oncological, and survival outcomes of patients undergoing pedicled and microsurgical flap reconstruction in NTG/TG patients at our hospital. Methodology: A prospective study was conducted for 7 years on 91 patients with carcinoma tongue who underwent NTG/TG at our institute. Patients underwent anterolateral thigh (ALT), free radial artery forearm flap (FRAFF), and pectoralis major myocutaneous (PMMC) flap reconstruction and were followed up for immediate complications and functional outcomes for speech, swallowing, and decannulation after completion of adjuvant treatment and then for survival rates for a period of 60 months and statistically analysed with log rank test and Fisher’s exact test for correlation. Results: Ninety-one (42.85%) patients underwent NTG, while 57.14% underwent TG. 85% of patients had >5 mm margin, 14% had ≤ of 5 mm, and none were positive. 57% of patients did not have postoperative complications and 10% underwent re-exploration. During follow-up, 85.7% of patients were able to take orally: 52% soft diet and 32% liquid diet. Multivariate analysis of individual flaps, swallowing, and speech intelligibility values were significant. After 5 years of postadjuvant therapy, there was 76% overall survival, 11% local recurrence and 12% had regional recurrence. Discussion: Morbidity and functional outcome depends on the extent of resection. PMMC flaps can be done on lack of expertise. FRAFF has better functional outcomes owing to pliability of flap. ALT and other bulky flaps require expertise and are prone to flap-related complications. Planning of reconstruction should be based on the defect size together with counseling of patients regarding the risk of complications and delay in adjuvant therapy.
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Kent RD, Rountrey C. What Acoustic Studies Tell Us About Vowels in Developing and Disordered Speech. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1749-1778. [PMID: 32631070 PMCID: PMC7893529 DOI: 10.1044/2020_ajslp-19-00178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 11/04/2019] [Accepted: 04/19/2020] [Indexed: 05/05/2023]
Abstract
Purpose Literature was reviewed on the development of vowels in children's speech and on vowel disorders in children and adults, with an emphasis on studies using acoustic methods. Method Searches were conducted with PubMed/MEDLINE, Google Scholar, CINAHL, HighWire Press, and legacy sources in retrieved articles. The primary search items included, but were not limited to, vowels, vowel development, vowel disorders, vowel formants, vowel therapy, vowel inherent spectral change, speech rhythm, and prosody. Results/Discussion The main conclusions reached in this review are that vowels are (a) important to speech intelligibility; (b) intrinsically dynamic; (c) refined in both perceptual and productive aspects beyond the age typically given for their phonetic mastery; (d) produced to compensate for articulatory and auditory perturbations; (e) influenced by language and dialect even in early childhood; (f) affected by a variety of speech, language, and hearing disorders in children and adults; (g) inadequately assessed by standardized articulation tests; and (h) characterized by at least three factors-articulatory configuration, extrinsic and intrinsic regulation of duration, and role in speech rhythm and prosody. Also discussed are stages in typical vowel ontogeny, acoustic characterization of rhotic vowels, a sensory-motor perspective on vowel production, and implications for clinical assessment of vowels.
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Affiliation(s)
- Ray D. Kent
- Waisman Center, University of Wisconsin–Madison
| | - Carrie Rountrey
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
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Effect of Ageing on Acoustic Characteristics of Voice Pitch and Formants in Czech Vowels. J Voice 2020; 35:931.e21-931.e33. [DOI: 10.1016/j.jvoice.2020.02.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 11/20/2022]
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Balaguer M, Pommée T, Farinas J, Pinquier J, Woisard V, Speyer R. Effects of oral and oropharyngeal cancer on speech intelligibility using acoustic analysis: Systematic review. Head Neck 2019; 42:111-130. [PMID: 31571334 DOI: 10.1002/hed.25949] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/06/2019] [Accepted: 08/26/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The development of automatic tools based on acoustic analysis allows to overcome the limitations of perceptual assessment for patients with head and neck cancer. The aim of this study is to provide a systematic review of literature describing the effects of oral and oropharyngeal cancer on speech intelligibility using acoustic analysis. METHODS Two databases (PubMed and Embase) were surveyed. The selection process, according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, led to a final set of 22 articles. RESULTS Nasalance is studied mainly in oropharyngeal patients. The vowels are mostly studied using formant analysis and vowel space area, the consonants by means of spectral moments with specific parameters according to their phonetic characteristic. Machine learning methods allow classifying "intelligible" or "unintelligible" speech for T3 or T4 tumors. CONCLUSIONS The development of comprehensive models combining different acoustic measures would allow a better consideration of the functional impact of the speech disorder.
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Affiliation(s)
- Mathieu Balaguer
- CHU Larrey, Toulouse, France.,IRIT, CNRS, Université Paul Sabatier, Toulouse, France
| | | | | | | | - Virginie Woisard
- CHU Larrey, Toulouse, France.,Laboratoire Octogone-Lordat, Toulouse, France
| | - Renée Speyer
- Faculty of Educational Sciences, University of Oslo, Oslo, Norway
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Dabbaghchian S, Arnela M, Engwall O, Guasch O. Reconstruction of vocal tract geometries from biomechanical simulations. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2019; 35:e3159. [PMID: 30242981 PMCID: PMC6587943 DOI: 10.1002/cnm.3159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 06/08/2023]
Abstract
Medical imaging techniques are usually utilized to acquire the vocal tract geometry in 3D, which may then be used, eg, for acoustic/fluid simulation. As an alternative, such a geometry may also be acquired from a biomechanical simulation, which allows to alter the anatomy and/or articulation to study a variety of configurations. In a biomechanical model, each physical structure is described by its geometry and its properties (such as mass, stiffness, and muscles). In such a model, the vocal tract itself does not have an explicit representation, since it is a cavity rather than a physical structure. Instead, its geometry is defined implicitly by all the structures surrounding the cavity, and such an implicit representation may not be suitable for visualization or for acoustic/fluid simulation. In this work, we propose a method to reconstruct the vocal tract geometry at each time step during the biomechanical simulation. Complexity of the problem, which arises from model alignment artifacts, is addressed by the proposed method. In addition to the main cavity, other small cavities, including the piriform fossa, the sublingual cavity, and the interdental space, can be reconstructed. These cavities may appear or disappear by the position of the larynx, the mandible, and the tongue. To illustrate our method, various static and temporal geometries of the vocal tract are reconstructed and visualized. As a proof of concept, the reconstructed geometries of three cardinal vowels are further used in an acoustic simulation, and the corresponding transfer functions are derived.
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Affiliation(s)
- Saeed Dabbaghchian
- Department of Speech, Music, and HearingKTH Royal Institute of TechnologyStockholmSweden
| | - Marc Arnela
- GTM Grup de recerca en Tecnologies Mèdia, La SalleUniversitat Ramon LlullBarcelonaSpain
| | - Olov Engwall
- Department of Speech, Music, and HearingKTH Royal Institute of TechnologyStockholmSweden
| | - Oriol Guasch
- GTM Grup de recerca en Tecnologies Mèdia, La SalleUniversitat Ramon LlullBarcelonaSpain
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Kent RD, Vorperian HK. Static measurements of vowel formant frequencies and bandwidths: A review. JOURNAL OF COMMUNICATION DISORDERS 2018; 74:74-97. [PMID: 29891085 PMCID: PMC6002811 DOI: 10.1016/j.jcomdis.2018.05.004] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/23/2018] [Accepted: 05/27/2018] [Indexed: 05/05/2023]
Abstract
PURPOSE Data on vowel formants have been derived primarily from static measures representing an assumed steady state. This review summarizes data on formant frequencies and bandwidths for American English and also addresses (a) sources of variability (focusing on speech sample and time sampling point), and (b) methods of data reduction such as vowel area and dispersion. METHOD Searches were conducted with CINAHL, Google Scholar, MEDLINE/PubMed, SCOPUS, and other online sources including legacy articles and references. The primary search items were vowels, vowel space area, vowel dispersion, formants, formant frequency, and formant bandwidth. RESULTS Data on formant frequencies and bandwidths are available for both sexes over the lifespan, but considerable variability in results across studies affects even features of the basic vowel quadrilateral. Origins of variability likely include differences in speech sample and time sampling point. The data reveal the emergence of sex differences by 4 years of age, maturational reductions in formant bandwidth, and decreased formant frequencies with advancing age in some persons. It appears that a combination of methods of data reduction provide for optimal data interpretation. CONCLUSION The lifespan database on vowel formants shows considerable variability within specific age-sex groups, pointing to the need for standardized procedures.
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Affiliation(s)
- Raymond D Kent
- Waisman Center, University of Wisconsin-Madison, United States.
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