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Budală DG, Lupu CI, Vasluianu RI, Ioanid N, Butnaru OM, Baciu ER. A Contemporary Review of Clinical Factors Involved in Speech-Perspectives from a Prosthodontist Point of View. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1322. [PMID: 37512133 PMCID: PMC10385982 DOI: 10.3390/medicina59071322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: Learning to speak properly requires a fully formed brain, good eyesight, and a functioning auditory system. Defective phonation is the outcome of a failure in the development of any of the systems or components involved in speech production. Dentures with strong phonetic skills can be fabricated with the help of a dentist who has a firm grasp of speech production and phonetic characteristics. Every dentist strives to perfect their craft by perfecting the balance between the technical, cosmetic, and acoustic aspects of dentistry, or "phonetics". The ideal prosthesis for a patient is one that not only sounds good but also functions well mechanically and aesthetically. Words are spoken by using articulators that alter their size and form. Conclusions: Therefore, a prosthesis should be made in such a way that it does not interfere with the ability to communicate. As a result, a prosthodontist has to have a solid grasp of how speech is made and the numerous parts that go into it.
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Affiliation(s)
- Dana Gabriela Budală
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Costin Iulian Lupu
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Roxana Ionela Vasluianu
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Nicoleta Ioanid
- Department of Fixed Prosthodontics, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania
| | - Oana Maria Butnaru
- Department of Biophysics, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena-Raluca Baciu
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
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Gheibollahi H, Mousavi S, Babaei A. Factors associated with survival and patient's quality of life after segmental mandibulectomy. Support Care Cancer 2023; 31:366. [PMID: 37253883 DOI: 10.1007/s00520-023-07831-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/23/2023] [Indexed: 06/01/2023]
Abstract
AIM This study aimed to explore the survival rate and quality of life (QoL) in patients who underwent segmental mandibulectomy and determine the associated factor with survival rate and QoL. MATERIAL AND METHODS In this cross-sectional study, all patients who underwent segmental mandibular resection in the referral center of Shiraz University of Medical Sciences, Iran, during 2015-2019 were included. Inclusion criteria were segmental mandibulectomy due to any pathology and age of more than 8 years old. Demographic, clinical data and patient survival were recorded. EORTC QLQ-HN43 was used to evaluate QoL. RESULTS Totally, 82 patients were studied. The overall 3-year survival rate was 69.5% (57 patients) (mean ± SD: 1.35 ± 1.03 years). According to univariate analysis, age (p-value = 0.001), hospital lengths of stay (p-value < 0.001), gender (p-value = 0.014, OR = 4.143), education (p-value = 0.015, OR = 0.291), pathology (p-value < 0.001, OR = 17.000), metastasis (p-value = 0.018, OR = 4.894), neck dissection (p-value < 0.001, OR = 52.381), frozen margin (p-value < 0.001 OR = 8.000), recurrence (p-value = 0.001, OR = 6.273), and status of chemoradiotherapy (p-value < 0.001) were significantly associated with survival rate. Logistic regression revealed that survival was associated with gender (p-value = 0.040, OR = 23.689), level of education (p-value = 0.019, OR = 0.019), and neck dissection (p-value = 0.019, OR = 175.781). According to univariate analysis, pathology (p-value = 0.003), neck dissection (p-value = 0.024), frozen margin (p-value = 0.004), and chemoradiotherapy (p-value = 0.026) were significantly associated with QoL. Linear regression revealed that QoL was associated with none of the measured factors. CONCLUSION In conclusion, gender, level of education, and neck dissection were related to 3-year patients' survival. None of the measured factors in this study were associated with QoL.
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Affiliation(s)
- Hamed Gheibollahi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sona Mousavi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
| | - Amirhossein Babaei
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.
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Wang Y, Hattori M, Masaki K, Sumita YI. Detailed speech evaluation including formant 3 analysis and voice visualization in maxillofacial rehabilitation: A clinical report. J Prosthet Dent 2023:S0022-3913(23)00221-4. [PMID: 37173176 DOI: 10.1016/j.prosdent.2023.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 05/15/2023]
Abstract
Objective speech evaluation such as analysis of formants 1 and 2 and nasality measurement have been used in maxillofacial rehabilitation for outcome assessment. However, in some patients, those evaluations are insufficient to assess a specific or unique problem. This report describes the use of a new speech evaluation including formant 3 analysis and voice visualization in a patient with a maxillofacial defect. The patient was a 67-year-old man who had a maxillary defect that opened to the maxillary sinus and who had an unnatural voice even when wearing an obturator. Nasality was low and the frequency of formants 1 and 2 were normal even without the obturator. However, a low frequency of formant 3 and a shifted center of voice were observed. These results indicated that the unnatural voice was related to increased resonant volume in the pharynx rather than hypernasality. This patient demonstrates that advanced speech analysis can be useful for detecting the cause of speech disorder and planning maxillofacial rehabilitation.
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Affiliation(s)
- Yujia Wang
- Graduate Student, Department of Advanced Prosthodontics, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Mariko Hattori
- Assistant Professor, Department of Advanced Prosthodontics, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
| | - Keita Masaki
- Speech-Language-Hearing Therapist, Clinic of Speech, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Yuka I Sumita
- Associate Professor, Department of Advanced Prosthodontics, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Ali IE, Sumita Y, Wakabayashi N. Comparison of Praat and Computerized Speech Lab for formant analysis of five Japanese vowels in maxillectomy patients. Front Neurosci 2023; 17:1098197. [PMID: 36816122 PMCID: PMC9928875 DOI: 10.3389/fnins.2023.1098197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
Introduction Speech impairment is a common complication after surgical resection of maxillary tumors. Maxillofacial prosthodontists play a critical role in restoring this function so that affected patients can enjoy better lives. For that purpose, several acoustic software packages have been used for speech evaluation, among which Computerized Speech Lab (CSL) and Praat are widely used in clinical and research contexts. Although CSL is a commercial product, Praat is freely available on the internet and can be used by patients and clinicians to practice several therapy goals. Therefore, this study aimed to determine if both software produced comparable results for the first two formant frequencies (F1 and F2) and their respective formant ranges obtained from the same voice samples from Japanese participants with maxillectomy defects. Methods CSL was used as a reference to evaluate the accuracy of Praat with both the default and newly proposed adjusted settings. Thirty-seven participants were enrolled in this study for formant analysis of the five Japanese vowels (a/i/u/e/o) using CSL and Praat. Spearman's rank correlation coefficient was used to judge the correlation between the analysis results of both programs regarding F1 and F2 and their respective formant ranges. Results As the findings pointed out, highly positive correlations between both software were found for all acoustic features and all Praat settings. Discussion The strong correlations between the results of both CSL and Praat suggest that both programs may have similar decision strategies for atypical speech and for both sexes. This study highlights that the default settings in Praat can be used for formant analysis in maxillectomy patients with predictable accuracy. The proposed adjusted settings in Praat can yield more accurate results for formant analysis of atypical speech in maxillectomy cases when the examiner cannot precisely locate the formant frequencies using the default settings or confirm analysis results obtained using CSL.
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Affiliation(s)
- Islam E. Ali
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan,Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Yuka Sumita
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan,*Correspondence: Yuka Sumita,
| | - Noriyuki Wakabayashi
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Wang Y, Hattori M, Liu R, Sumita YI. Digital acoustic analysis of the first three formant frequencies in patients with a prosthesis after maxillectomy. J Prosthet Dent 2022:S0022-3913(22)00654-0. [PMID: 36460491 DOI: 10.1016/j.prosdent.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 11/30/2022]
Abstract
STATEMENT OF PROBLEM Prosthetic rehabilitation with an obturator can help to restore or improve the intelligibility of speech in patients after maxillectomy. The frequency of formants 1 and 2 as well as their ranges were initially reported in patients with maxillary defects in 2002, and the evaluation method that was used is now applied in clinical evaluation. However, the details of formant 3 are not known and warrant investigation because, according to speech science, formant 3 is related to the pharyngeal volume. Clarifying the formant frequency values of formant 3 in patients after maxillectomy would enable prosthodontists to refer to these data when planning treatment and when assessing the outcome of an obturator. PURPOSE The purpose of this clinical study was to determine the acoustic characteristics of formant 3, together with those of formants 1 and 2, by using a digital acoustic analysis during maxillofacial prosthetic treatment. The utility of determining formant 3 in the evaluation of speech in patients after maxillectomy was also evaluated. MATERIAL AND METHODS Twenty-six male participants after a maxillectomy (mean age, 63 years; range, 20 to 93 years) were included, and the 5 Japanese vowels /a/, /e/, /i/, /o/, and /u/ produced with and without a definitive obturator prosthesis were recorded. The frequencies of the 3 formants were determined, and their ranges were calculated by using a speech analysis system (Computerized Speech Lab CSL 4400). The Wilcoxon signed rank test was used to compare the formants between the 2 use conditions (α=0.05). RESULTS Significant differences were found in the frequencies and ranges of all 3 formants between the use conditions. The ranges of all 3 formants produced with the prosthesis were significantly greater than those produced without it. CONCLUSIONS Based on the findings, both the first 2 formants and the third formant were changed by wearing an obturator prosthesis. Because formant 3 is related to the volume of the pharynx, evaluation of this formant and its range can reflect the effectiveness of the prosthesis to seal the oronasal communication and help reduce hypernasality, suggesting the utility of formant 3 analysis in prosthodontic rehabilitation.
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Affiliation(s)
- Yujia Wang
- Graduate student, Department of Maxillofacial Prosthetics, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Mariko Hattori
- Assistant Professor, Department of Maxillofacial Prosthetics, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
| | - Rongguang Liu
- Clinical Staff, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yuka I Sumita
- Associate Professor, Department of Maxillofacial Prosthetics, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Murase M, Tani H, Sumita YI, Ino S, Taniguchi H. Nutritional assessment in a maxillectomy patient from the preoperative period to definitive obturator insertion: A case report. J Prosthodont Res 2021; 66:514-518. [PMID: 34645718 DOI: 10.2186/jpr.jpr_d_20_00250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PATIENT A 69-year-old Japanese male with squamous cell carcinoma of the right maxilla (T4M0N0) was referred to our department for a preoperative examination. An immediate surgical obturator was fabricated before surgery. He underwent surgical treatment, which included right subtotal maxillectomy and reconstruction with a split skin graft. One week postoperatively, the immediate surgical obturator was modified to expand the nasal cavity for obturator prosthesis. Oral intake was started 12 days postoperatively with an immediate surgical obturator in situ. The definitive obturator was fabricated after the wound surface had healed 8 months postoperatively. Assessment of the nutritional status included body mass index, serum albumin level, resting energy expenditure (REE) measured using indirect calorimetry, and predicted REE using the Harris-Benedict equation. These assessments were performed several times, from the time of admission until the definitive obturator was applied. DISCUSSION Malnutrition occurs frequently in patients with head and neck cancer because this region is vital for swallowing and mastication. Maxillectomy patients require a maxillofacial prosthesis to improve their nutritional status from the preoperative period to recovery. This case report describes maxillofacial prosthetic treatment from the perspective of nutrition. The patient wore the immediate surgical obturator postoperatively, which was followed by marked weight loss after restoration, and then weight gain returned to the normal range when wearing the definitive obturator. CONCLUSION Maxillofacial prosthetic treatments should make efforts to maintain nutritional status and achieve optimal function and quality of life in patients with head and neck cancers.
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Affiliation(s)
- Mai Murase
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroko Tani
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuka I Sumita
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shuichi Ino
- Division of Mechanical Engineering, Graduate School of Engineering, Osaka University, Osaka, Japan
| | - Hisashi Taniguchi
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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Davudov MM, Harirchi I, Arabkheradmand A, Garajei A, Mirzajani Z, Amiraliyev K, Rustamli N, Zebardast J, Montazeri A. Quality of life in patients with oral cancer treated by different reconstruction methods as measured by the EORTC QLQ-H&N43. Br J Oral Maxillofac Surg 2020; 58:e67-e74. [PMID: 32646789 DOI: 10.1016/j.bjoms.2020.06.027] [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: 06/19/2019] [Accepted: 06/17/2020] [Indexed: 11/12/2022]
Abstract
This was a prospective clinical study and the purpose was to assess the quality of life (QoL) as the primary endpoint for patients given prospective treatment for cancer of the oral cavity that required reconstruction using various reconstruction methods in Azerbaijan. All patients who were operated on during the year 2017 to 2018 were entered into the study. Quality of life was assessed six months postoperatively using the European Organization for Research and Cancer Treatment Core Cancer Quality of Life (EORTC QLQ-C30) and the Head and Neck Specific Quality of Life (QLQ-H&NN43) questionnaires. A total of 96 patients completed the questionnaires. There were 36 patients who did not receive a flap, 31 patients received a local flap, and 29 patients had distant-regional flaps. QoL assessed by the EORTC QLQ-C30, and the QLQ-H&N43 was lower in patients who received a local flap. In general, the results showed that the reconstruction with a distant-regional flap compared with no flap and local flap leads to improved quality of life of patients with oral cancer.
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Affiliation(s)
- M M Davudov
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan.
| | - I Harirchi
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - A Arabkheradmand
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - A Garajei
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Z Mirzajani
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan.
| | - K Amiraliyev
- Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan.
| | - N Rustamli
- Department of Oral and Maxillofacial Surgery, Azerbaijan Medical University, Baku, Azerbaijan.
| | - J Zebardast
- Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - A Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.
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