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Erattakulangara S, Kelat K, Meyer D, Priya S, Lingala SG. Automatic Multiple Articulator Segmentation in Dynamic Speech MRI Using a Protocol Adaptive Stacked Transfer Learning U-NET Model. Bioengineering (Basel) 2023; 10:bioengineering10050623. [PMID: 37237693 DOI: 10.3390/bioengineering10050623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/11/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
Dynamic magnetic resonance imaging has emerged as a powerful modality for investigating upper-airway function during speech production. Analyzing the changes in the vocal tract airspace, including the position of soft-tissue articulators (e.g., the tongue and velum), enhances our understanding of speech production. The advent of various fast speech MRI protocols based on sparse sampling and constrained reconstruction has led to the creation of dynamic speech MRI datasets on the order of 80-100 image frames/second. In this paper, we propose a stacked transfer learning U-NET model to segment the deforming vocal tract in 2D mid-sagittal slices of dynamic speech MRI. Our approach leverages (a) low- and mid-level features and (b) high-level features. The low- and mid-level features are derived from models pre-trained on labeled open-source brain tumor MR and lung CT datasets, and an in-house airway labeled dataset. The high-level features are derived from labeled protocol-specific MR images. The applicability of our approach to segmenting dynamic datasets is demonstrated in data acquired from three fast speech MRI protocols: Protocol 1: 3 T-based radial acquisition scheme coupled with a non-linear temporal regularizer, where speakers were producing French speech tokens; Protocol 2: 1.5 T-based uniform density spiral acquisition scheme coupled with a temporal finite difference (FD) sparsity regularization, where speakers were producing fluent speech tokens in English, and Protocol 3: 3 T-based variable density spiral acquisition scheme coupled with manifold regularization, where speakers were producing various speech tokens from the International Phonetic Alphabetic (IPA). Segments from our approach were compared to those from an expert human user (a vocologist), and the conventional U-NET model without transfer learning. Segmentations from a second expert human user (a radiologist) were used as ground truth. Evaluations were performed using the quantitative DICE similarity metric, the Hausdorff distance metric, and segmentation count metric. This approach was successfully adapted to different speech MRI protocols with only a handful of protocol-specific images (e.g., of the order of 20 images), and provided accurate segmentations similar to those of an expert human.
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Affiliation(s)
- Subin Erattakulangara
- Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242, USA
| | - Karthika Kelat
- Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242, USA
| | - David Meyer
- Janette Ogg Voice Research Center, Shenandoah University, Winchester, VA 22601, USA
| | - Sarv Priya
- Department of Radiology, University of Iowa, Iowa City, IA 52242, USA
| | - Sajan Goud Lingala
- Roy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242, USA
- Department of Radiology, University of Iowa, Iowa City, IA 52242, USA
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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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Zhou J, Li K, Qin H, Xie B, Liao H, Su X, Li C, He X, Chen W, Jiang X. Programmed-stimuli responsive carrier-free multidrug delivery system for highly efficient trimodal combination therapy. J Colloid Interface Sci 2023; 637:453-464. [PMID: 36716669 DOI: 10.1016/j.jcis.2023.01.091] [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: 09/09/2022] [Revised: 12/22/2022] [Accepted: 01/19/2023] [Indexed: 01/24/2023]
Abstract
Programmed response, carrier-free, and multimodal therapy drug delivery systems (DDS) are promising solutions to multidirectional cytotoxic effects, inefficient antitumor, and severe side effects for cancer therapy. Here, three widely used clinical drugs, interferon α1b (IFNα1b), indocyanine green (ICG), and doxorubicin (DOX), were prepared into carrier-free DDS IFNα1b-ICG-DOX (IID) by a simple one-step method without additional any reagents. IID can achieve smart and programmed DDS by combining low pH and near-infrared (NIR) light stimuli-responsive controlled release. In pH = 7.4 environments, our IID is about 380 nm in size with negative charge rounded particles; while they enter into the acid environment (pH < 7), hydrogen ions (H+) trigger DOX release, their size becomes larger and the surface charge turns positive. These larger particles are rapidly disintegrated after exposure to NIR light and then the remaining DOX, IFNα1b, and ICG are released. In vivo, the IID with larger size and positive charge resulting from low pH is is easy to accumulate in tumor tissue. Tumors can be exposed to NIR light when needed to control the release of these three drugs. Hence, DOX, ICG, and IFNα1b can be enriched in the tumor to the high efficiency of combined chemotherapy, photothermal therapy, and immunotherapy.
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Affiliation(s)
- Jun Zhou
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China; Conservative Dentistry & Endodontics Department College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning 530021, China; Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China
| | - Kangjing Li
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China; Conservative Dentistry & Endodontics Department College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning 530021, China; Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China
| | - Hejia Qin
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China; Conservative Dentistry & Endodontics Department College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning 530021, China; Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China
| | - Beibei Xie
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China; Conservative Dentistry & Endodontics Department College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning 530021, China; Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China
| | - Haiqin Liao
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China; Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China
| | - Xiaoping Su
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China
| | - Cuiping Li
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China
| | - Xuan He
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China; Conservative Dentistry & Endodontics Department College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning 530021, China; Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China
| | - Wenxia Chen
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China; Conservative Dentistry & Endodontics Department College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning 530021, China; Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China.
| | - Xinglu Jiang
- Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction College of Stomatology, Hospital of Stomatology, Guangxi Medical University Nanning 530021, China; Conservative Dentistry & Endodontics Department College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning 530021, China; Clinical Laboratory Medicine Department, College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning 530021, China.
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Guo K, Xiao Y, Deng W, Zhao G, Zhang J, Liang Y, Yang L, Liao G. Speech disorders in patients with Tongue squamous cell carcinoma: A longitudinal observational study based on a questionnaire and acoustic analysis. BMC Oral Health 2023; 23:192. [PMID: 37005608 PMCID: PMC10068158 DOI: 10.1186/s12903-023-02888-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/15/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Speech disorders are common dysfunctions in patients with tongue squamous cell carcinoma (TSCC) that can diminish their quality of life. There are few studies with multidimensional and longitudinal assessments of speech function in TSCC patients. METHODS This longitudinal observational study was conducted at the Hospital of Stomatology, Sun Yat-sen University, China, from January 2018 to March 2021. A cohort of 92 patients (53 males, age range: 24-77 years) diagnosed with TSCC participated in this study. Speech function was assessed from preoperatively to one year postoperatively using the Speech Handicap Index questionnaire and acoustic parameters. The risk factors for postoperative speech disorder were analyzed by a linear mixed-effects model. A t test or Mann‒Whitney U test was applied to analyze the differences in acoustic parameters under the influence of risk factors to determine the pathophysiological mechanisms of speech disorders in patients with TSCC. RESULTS The incidence of preoperative speech disorders was 58.7%, which increased up to 91.4% after surgery. Higher T stage (P<0.001) and larger range of tongue resection (P = 0.002) were risk factors for postoperative speech disorders. Among the acoustic parameters, F2/i/decreased remarkably with higher T stage (P = 0.021) and larger range of tongue resection (P = 0.009), indicating restricted tongue movement in the anterior-posterior direction. The acoustic parameters analysis during the follow-up period showed that F1 and F2 were not significantly different of the patients with subtotal or total glossectomy over time. CONCLUSIONS Speech disorders in TSCC patients is common and persistent. Less residual tongue volume led to worse speech-related QoL, indicating that surgically restoring the length of the tongue and strengthening tongue extension postoperatively may be important.
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Affiliation(s)
- Kaixin Guo
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, Guangdong, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, No.74, 2nd Zhongshan Road, Guangzhou, Guangdong, 510080, China
| | - Yudong Xiao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, Guangdong, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, No.74, 2nd Zhongshan Road, Guangzhou, Guangdong, 510080, China
| | - Wei Deng
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, Guangdong, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, No.74, 2nd Zhongshan Road, Guangzhou, Guangdong, 510080, China
| | - Guiyi Zhao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, Guangdong, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, No.74, 2nd Zhongshan Road, Guangzhou, Guangdong, 510080, China
| | - Jie Zhang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, Guangdong, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, No.74, 2nd Zhongshan Road, Guangzhou, Guangdong, 510080, China
| | - Yujie Liang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, Guangdong, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, No.74, 2nd Zhongshan Road, Guangzhou, Guangdong, 510080, China
| | - Le Yang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, Guangdong, 510055, China.
- Guangdong Provincial Key Laboratory of Stomatology, No.74, 2nd Zhongshan Road, Guangzhou, Guangdong, 510080, China.
| | - Guiqing Liao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, Guangdong, 510055, China.
- Guangdong Provincial Key Laboratory of Stomatology, No.74, 2nd Zhongshan Road, Guangzhou, Guangdong, 510080, China.
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Ruthven M, Miquel ME, King AP. A segmentation-informed deep learning framework to register dynamic two-dimensional magnetic resonance images of the vocal tract during speech. Biomed Signal Process Control 2023; 80:104290. [PMID: 36743699 PMCID: PMC9746295 DOI: 10.1016/j.bspc.2022.104290] [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: 08/04/2022] [Revised: 09/29/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
Abstract
Objective Dynamic magnetic resonance (MR) imaging enables visualisation of articulators during speech. There is growing interest in quantifying articulator motion in two-dimensional MR images of the vocal tract, to better understand speech production and potentially inform patient management decisions. Image registration is an established way to achieve this quantification. Recently, segmentation-informed deformable registration frameworks have been developed and have achieved state-of-the-art accuracy. This work aims to adapt such a framework and optimise it for estimating displacement fields between dynamic two-dimensional MR images of the vocal tract during speech. Methods A deep-learning-based registration framework was developed and compared with current state-of-the-art registration methods and frameworks (two traditional methods and three deep-learning-based frameworks, two of which are segmentation informed). The accuracy of the methods and frameworks was evaluated using the Dice coefficient (DSC), average surface distance (ASD) and a metric based on velopharyngeal closure. The metric evaluated if the fields captured a clinically relevant and quantifiable aspect of articulator motion. Results The segmentation-informed frameworks achieved higher DSCs and lower ASDs and captured more velopharyngeal closures than the traditional methods and the framework that was not segmentation informed. All segmentation-informed frameworks achieved similar DSCs and ASDs. However, the proposed framework captured the most velopharyngeal closures. Conclusions A framework was successfully developed and found to more accurately estimate articulator motion than five current state-of-the-art methods and frameworks. Significance The first deep-learning-based framework specifically for registering dynamic two-dimensional MR images of the vocal tract during speech has been developed and evaluated.
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Affiliation(s)
- Matthieu Ruthven
- Clinical Physics, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, United Kingdom,School of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, United Kingdom,Corresponding author at: Clinical Physics, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, United Kingdom.
| | - Marc E. Miquel
- Clinical Physics, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, United Kingdom,Digital Environment Research Institute (DERI), Empire House, 67-75 New Road, Queen Mary University of London, London E1 1HH, United Kingdom,Advanced Cardiovascular Imaging, Barts NIHR BRC, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - Andrew P. King
- School of Biomedical Engineering & Imaging Sciences, King’s College London, King’s Health Partners, St Thomas’ Hospital, London SE1 7EH, United Kingdom
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Paul M, Itoo AM, Ghosh B, Biswas S. Hypoxia alleviating platinum(IV)/chlorin e6-based combination chemotherapeutic-photodynamic nanomedicine for oropharyngeal carcinoma. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2023; 238:112627. [PMID: 36525775 DOI: 10.1016/j.jphotobiol.2022.112627] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/09/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022]
Abstract
Hypoxia is an important pathological hallmark of the tumor microenvironment, associated with metabolic alterations, cell proliferation, aggressiveness, metastasis, and therapy resistance in cancers. Hypoxia impedes the outcome of photodynamic therapy (PDT), which is largely dependent on molecular oxygen to generate cytotoxic 1O2. Here, a near-infrared light activatable, oxygen-generating nanomicellar PDT-chemotherapy system (mPPCPN Ms) constituted of amphiphilic mPEG-PLA, photosensitizer Ce6, and tetravalent platinum prodrug Pt(IV)-diazide was developed for oral squamous cell carcinoma. The polymer conjugate self-assemble to nanosize (115 ± 2.35 nm) micelles, which, upon irradiation (660 nm laser), activated Ce6, and photodecomposed to produce cytotoxic Pt(II), azidyl radical, and molecular oxygen. The strategically fabricated PDT-chemotherapy produced a strong antitumor response in vitro using oral squamous cell carcinoma and in vivo in oral cancer-xenografted mouse models, revealing its significant potential in chemo-photodynamic combination therapy with the benefit of reversing hypoxia.
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Affiliation(s)
- Milan Paul
- Nanomedicine Research Laboratory, Department of Pharmacy, Birla Institute of Technology & Science-Pilani, Hyderabad Campus, Jawahar Nagar, Medchal, Hyderabad 500078, Telangana, India
| | - Asif Mohd Itoo
- Nanomedicine Research Laboratory, Department of Pharmacy, Birla Institute of Technology & Science-Pilani, Hyderabad Campus, Jawahar Nagar, Medchal, Hyderabad 500078, Telangana, India
| | - Balaram Ghosh
- Nanomedicine Research Laboratory, Department of Pharmacy, Birla Institute of Technology & Science-Pilani, Hyderabad Campus, Jawahar Nagar, Medchal, Hyderabad 500078, Telangana, India
| | - Swati Biswas
- Nanomedicine Research Laboratory, Department of Pharmacy, Birla Institute of Technology & Science-Pilani, Hyderabad Campus, Jawahar Nagar, Medchal, Hyderabad 500078, Telangana, India.
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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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Sarin V, Chatterjee A, Kakkar V, Juneja A. Evaluation of Tongue Functions After Free Flap Reconstruction. Indian J Otolaryngol Head Neck Surg 2022; 74:2398-2403. [PMID: 36452650 PMCID: PMC9701944 DOI: 10.1007/s12070-020-02177-1] [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: 08/14/2020] [Accepted: 09/23/2020] [Indexed: 10/23/2022] Open
Abstract
Squamous cell carcinoma of the tongue is the most common malignancy of the oral cavity, the lateral border being the commonest site. The treatment strategies mandate surgery followed by appropriate reconstruction as the first line of management. There are many suitable methods of reconstruction of tongue defects after surgery, but the principle of an ideal reconstruction method should provide not only satisfactory structural cosmesis, but also good restoration of function. We present our experience with the skin lined free flaps reconstruction for defects of the tongue and floor of mouth, and present analyses of the functional outcomes of reconstruction. This prospective longitudinal study included 93 patients and was conducted in a tertiary care center in Punjab. All patients underwent free flap reconstruction after tumor removal. The functional outcome of the tongue following reconstruction was evaluated 9 months after the completion of treatment. Functions were assessed and matched with sexes and age-matched normal individuals. The data obtained were analyzed by the student 't' test and the p values < 0.05 were considered statistically significant. The duration of swallowing in patients with FRF flap and ALT flap when compared to the normative was significant (< 0.05). There were changes in configuration and volume of the oral cavity after surgery which generates resonant and articulatory alterations, thus the intelligibility of the patient's speech is lowered. There is also a restriction in the tongue movements and reduction in the sensations of the reconstructed part of the tongue. Both the free ALT flap and the FRF flap can provide acceptable functional restoration of the tongue after radical tumor resection.
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Affiliation(s)
- Vanita Sarin
- Department of Otorhinolaryngology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Arpita Chatterjee
- Department of Audiology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Vikas Kakkar
- Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
| | - Ateev Juneja
- Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
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Olek M, Machorowska-Pieniążek A, Olek K, Cieślar G, Kawczyk-Krupka A. Photodynamic therapy in the treatment of oral squamous cell carcinoma - The state of the art in preclinical research on the animal model. Photodiagnosis Photodyn Ther 2021; 34:102236. [PMID: 33639322 DOI: 10.1016/j.pdpdt.2021.102236] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Oral cavity squamous cell carcinoma is a common cancer of the head and neck region. Due to the frequency of diagnoses, high rate of mortality, mutilating nature of classic therapy and numerous complications, new methods of treatment are being sought. One promising solution for treatment that is utilized in many fields of oncology is photodynamic therapy. The purpose of this article is to present a general overview of the use of photodynamic therapy in preclinical in vivo studies on the animal model. MATERIAL AND METHODS A literature search for articles corresponding to the topic of this review was performed using the PubMed and MEDLINE databases using the following keywords: 'oral cavity squamous cell carcinoma,' 'photodynamic therapy,' 'photosensitizer(s),' 'in vivo', and 'animal model'. RESULTS Based on the literature review, the two most used animal models can be distinguished in research on the use of photodynamic therapy for oral squamous cell carcinoma. Studies mainly focus on the evaluation of tumor growth inhibition after using therapies with various photosensitizers on the murine or hamster cheek pouch models. CONCLUDING REMARKS The animal model is a part of preclinical research. Unfortunately, each of the models has its limitations, so it is difficult to extrapolate the results to clinical trials.
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Affiliation(s)
- Marcin Olek
- Department of Orthodontics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | | | - Katarzyna Olek
- Department of Dental Propedeutics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Grzegorz Cieślar
- Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Aleksandra Kawczyk-Krupka
- Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland.
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Ruthven M, Miquel ME, King AP. Deep-learning-based segmentation of the vocal tract and articulators in real-time magnetic resonance images of speech. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 198:105814. [PMID: 33197740 PMCID: PMC7732702 DOI: 10.1016/j.cmpb.2020.105814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/19/2020] [Indexed: 06/01/2023]
Abstract
BACKGROUND AND OBJECTIVE Magnetic resonance (MR) imaging is increasingly used in studies of speech as it enables non-invasive visualisation of the vocal tract and articulators, thus providing information about their shape, size, motion and position. Extraction of this information for quantitative analysis is achieved using segmentation. Methods have been developed to segment the vocal tract, however, none of these also fully segment any articulators. The objective of this work was to develop a method to fully segment multiple groups of articulators as well as the vocal tract in two-dimensional MR images of speech, thus overcoming the limitations of existing methods. METHODS Five speech MR image sets (392 MR images in total), each of a different healthy adult volunteer, were used in this work. A fully convolutional network with an architecture similar to the original U-Net was developed to segment the following six regions in the image sets: the head, soft palate, jaw, tongue, vocal tract and tooth space. A five-fold cross-validation was performed to investigate the segmentation accuracy and generalisability of the network. The segmentation accuracy was assessed using standard overlap-based metrics (Dice coefficient and general Hausdorff distance) and a novel clinically relevant metric based on velopharyngeal closure. RESULTS The segmentations created by the method had a median Dice coefficient of 0.92 and a median general Hausdorff distance of 5mm. The method segmented the head most accurately (median Dice coefficient of 0.99), and the soft palate and tooth space least accurately (median Dice coefficients of 0.92 and 0.93 respectively). The segmentations created by the method correctly showed 90% (27 out of 30) of the velopharyngeal closures in the MR image sets. CONCLUSIONS An automatic method to fully segment multiple groups of articulators as well as the vocal tract in two-dimensional MR images of speech was successfully developed. The method is intended for use in clinical and non-clinical speech studies which involve quantitative analysis of the shape, size, motion and position of the vocal tract and articulators. In addition, a novel clinically relevant metric for assessing the accuracy of vocal tract and articulator segmentation methods was developed.
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Affiliation(s)
- Matthieu Ruthven
- Clinical Physics, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, London SE1 7EH, United Kingdom.
| | - Marc E Miquel
- Clinical Physics, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, United Kingdom; Centre for Advanced Cardiovascular Imaging, NIHR Barts Biomedical Research Centre, William Harvey Institute, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - Andrew P King
- School of Biomedical Engineering & Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, London SE1 7EH, United Kingdom
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11
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Girod-Roux M, Hueber T, Fabre D, Gerber S, Canault M, Bedoin N, Acher A, Béziaud N, Truy E, Badin P. Rehabilitation of speech disorders following glossectomy, based on ultrasound visual illustration and feedback. CLINICAL LINGUISTICS & PHONETICS 2020; 34:826-843. [PMID: 31992079 DOI: 10.1080/02699206.2019.1700310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 11/27/2019] [Accepted: 11/29/2019] [Indexed: 06/10/2023]
Abstract
Intraoral surgery for tongue cancer usually induces speech disorders that have a negative impact on communication and quality of life. Studies have documented the benefit of tongue ultrasound imaging as a visual articulatory feedback for speech rehabilitation. This study aims to assess specifically the complementary contribution of visual feedback to visual illustration (i.e. the display of ultrasound video of target language movements) for the speech rehabilitation of glossectomised patients. Two therapy conditions were used alternately for ten glossectomised French patients randomly divided into two cohorts. The IF cohort benefitted from 10 sessions using illustration alone (IL condition) followed by 10 sessions using illustration supplemented by visual feedback (IL+F condition). The FI cohort followed the opposite protocol, i.e. the first 10 sessions with the IL+F condition, followed by 10 sessions with the IL condition. Phonetic accuracy (Percent Consonants Correct) was monitored at baseline (T0, before the first series) and after each series (T1 and T2) using clinical speech-language assessments. None of the contrasts computed between the two conditions, using logistic regression with random effects models, were found to be statistically significant for the group analysis of assessment scores. Results were significant for a few individuals, with balanced advantages in both conditions. In conclusion, the use of articulatory visual feedback does not seem to bring a decisive advantage over the use of visual illustration, though speech therapists and patients reported that ultrasound feedback was useful at the beginning. This result should be confirmed by similar studies involving other types of speech disorders.
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Affiliation(s)
- Marion Girod-Roux
- GIPSA-lab, UMR 5216, CNRS - Grenoble Alpes University , Grenoble, France
- Centre Médical Rocheplane , Saint-Martin d'Hères, France
| | - Thomas Hueber
- GIPSA-lab, UMR 5216, CNRS - Grenoble Alpes University , Grenoble, France
| | - Diandra Fabre
- GIPSA-lab, UMR 5216, CNRS - Grenoble Alpes University , Grenoble, France
| | - Silvain Gerber
- GIPSA-lab, UMR 5216, CNRS - Grenoble Alpes University , Grenoble, France
| | - Mélanie Canault
- Laboratoire Dynamique du Langage, UMR 5596, CNRS, Université Lumière Lyon 2, & Institut des Sciences et Techniques de la Réadaptation, Université Claude Bernard , Lyon, France
| | - Nathalie Bedoin
- Laboratoire Dynamique du Langage, UMR 5596, CNRS, Université Lumière Lyon 2, & Institut des Sciences et Techniques de la Réadaptation, Université Claude Bernard , Lyon, France
| | - Audrey Acher
- Unité Neuro-Vasculaire, Pôle Psychiatrie-Neurologie-Rééducation, CHU Grenoble Alpes , Grenoble, France
| | | | - Eric Truy
- Département d'ORL, de Chirurgie cervico-maxillo-faciale et d'Audiophonologie, Groupement Hospitalier Edouard Herriot , Lyon, France
- ImpAct (Integrative multisensory perception Action cognition team) Lyon Neuroscience Research Center - CRNL (Inserm U1028, CNRS UMR5292) , Lyon, France
| | - Pierre Badin
- GIPSA-lab, UMR 5216, CNRS - Grenoble Alpes University , Grenoble, France
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12
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Martin J, Ruthven M, Boubertakh R, Miquel ME. Realistic Dynamic Numerical Phantom for MRI of the Upper Vocal Tract. J Imaging 2020; 6:86. [PMID: 34460743 PMCID: PMC8320850 DOI: 10.3390/jimaging6090086] [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: 06/26/2020] [Revised: 08/08/2020] [Accepted: 08/24/2020] [Indexed: 11/16/2022] Open
Abstract
Dynamic and real-time MRI (rtMRI) of human speech is an active field of research, with interest from both the linguistics and clinical communities. At present, different research groups are investigating a range of rtMRI acquisition and reconstruction approaches to visualise the speech organs. Similar to other moving organs, it is difficult to create a physical phantom of the speech organs to optimise these approaches; therefore, the optimisation requires extensive scanner access and imaging of volunteers. As previously demonstrated in cardiac imaging, realistic numerical phantoms can be useful tools for optimising rtMRI approaches and reduce reliance on scanner access and imaging volunteers. However, currently, no such speech rtMRI phantom exists. In this work, a numerical phantom for optimising speech rtMRI approaches was developed and tested on different reconstruction schemes. The novel phantom comprised a dynamic image series and corresponding k-space data of a single mid-sagittal slice with a temporal resolution of 30 frames per second (fps). The phantom was developed based on images of a volunteer acquired at a frame rate of 10 fps. The creation of the numerical phantom involved the following steps: image acquisition, image enhancement, segmentation, mask optimisation, through-time and spatial interpolation and finally the derived k-space phantom. The phantom was used to: (1) test different k-space sampling schemes (Cartesian, radial and spiral); (2) create lower frame rate acquisitions by simulating segmented k-space acquisitions; (3) simulate parallel imaging reconstructions (SENSE and GRAPPA). This demonstrated how such a numerical phantom could be used to optimise images and test multiple sampling strategies without extensive scanner access.
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Affiliation(s)
- Joe Martin
- MR Physics, Guy’s and St Thomas’ NHS Foundation Trust, St Thomas’s Hospital, London SE1 7EH, UK;
| | - Matthieu Ruthven
- Clinical Physics, Barts Health NHS Trust, St Bartholomew’s Hospital, London EC1A 7BE, UK;
| | - Redha Boubertakh
- Singapore Bioimaging Consortium (SBIC), Singapore 138667, Singapore;
| | - Marc E. Miquel
- Clinical Physics, Barts Health NHS Trust, St Bartholomew’s Hospital, London EC1A 7BE, UK;
- Centre for Advanced Cardiovascular Imaging, NIHR Barts Biomedical Research Centre (BRC), William Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK
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13
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Gomez AD, Stone ML, Woo J, Xing F, Prince JL. Analysis of fiber strain in the human tongue during speech. Comput Methods Biomech Biomed Engin 2020; 23:312-322. [PMID: 32031425 DOI: 10.1080/10255842.2020.1722808] [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] [Indexed: 10/25/2022]
Abstract
This study investigates mechanical cooperation among tongue muscles. Five volunteers were imaged using tagged magnetic resonance imaging to quantify spatiotemporal kinematics while speaking. Waveforms of strain in the line of action of fibers (SLAF) were estimated by projecting strain tensors onto a model of fiber directionality. SLAF waveforms were temporally aligned to determine consistency across subjects and correlation across muscles. The cohort exhibited consistent patterns of SLAF, and muscular extension-contraction was correlated. Volume-preserving tongue movement in speech generation can be achieved through multiple paths, but the study reveals similarities in motion patterns and muscular action-despite anatomical (and other) dissimilarities.
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Affiliation(s)
- Arnold D Gomez
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Maureen L Stone
- Department of Neural and Pain Sciences, University of Maryland, Baltimore, MD, USA
| | - Jonghye Woo
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Fangxu Xing
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Jerry L Prince
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
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14
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Wei M, Wu Y, Liu H, Xie C. Genipin Induces Autophagy and Suppresses Cell Growth of Oral Squamous Cell Carcinoma via PI3K/AKT/MTOR Pathway. DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:395-405. [PMID: 32099325 PMCID: PMC6996293 DOI: 10.2147/dddt.s222694] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 12/30/2019] [Indexed: 12/25/2022]
Abstract
Background Oral squamous cell carcinoma (OSCC) is a common malignant tumor of the head and neck, and it accounts for more than 90% of oral cancer. Due to high mortality, limitations of traditional treatment and many complications, new treatment methods are urgently needed. This study aimed to look into the effect of new potential anti-tumor drug, genipin, on OSCC treatment. Methods In vitro, CCK-8, colony formation, and flow cytometry were used to detect the effect of genipin on SCC-9 and SCC-15 cell lines. Immunofluorescence, real-time PCR, and Western blotting were used to investigate its mechanism. Xenograft tumor model was used to explore the role of genipin in vivo. Results We found that genipin suppressed cell growth and induced apoptosis in vitro. In addition, the expression of p62 was down-regulated while Beclin1 and LC3II were up-regulated in SCC-25 and SCC-9 cells. 3-methyladenine (3-MA) significantly decreased LC3 (LC3II)+ puncta, but genipin rescuect 3d this reduction. Furthermore, genipin also reduced the expression of p-PI3K, p-AKT, and p-mTOR. In vivo experiment showed that genipin significantly curbed the tumor size and weight. The positive expression of Ki67 protein and number of apoptotic cells were increased. Conclusion Conclusively, this study implicated that genipin suppresses cell proliferation and stimulated apoptosis, and is the first exploration showing that genipin induces OSCC cell autophagy via PI3K/AKT/mTOR pathway inhibition.
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Affiliation(s)
- MingBo Wei
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - YanLi Wu
- Department of Pharmacy, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - Hui Liu
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - Chun Xie
- Stomatology Center, Affiliated Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, People's Republic of China
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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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16
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Olek M, Kasperski J, Skaba D, Wiench R, Cieślar G, Kawczyk-Krupka A. Photodynamic therapy for the treatment of oral squamous carcinoma—Clinical implications resulting from in vitro research. Photodiagnosis Photodyn Ther 2019; 27:255-267. [DOI: 10.1016/j.pdpdt.2019.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 06/16/2019] [Accepted: 06/17/2019] [Indexed: 12/27/2022]
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17
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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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