Predictors of speech and swallowing function following primary surgery for oral and oropharyngeal cancer

Zuydam, A., Lowe, D., Brown, J.S., Vaughan, E. and Rogers, Simon (2005) Predictors of speech and swallowing function following primary surgery for oral and oropharyngeal cancer. Clinical Otolaryngology & Allied Sciences, 30 (5). pp. 428-437. ISSN 1749-4478 DOI

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Objectives:  To examine the association between the speech and swallowing aspect of health-related quality of life (HRQOL) and selected clinical parameters, and particularly to determine those that are predictive of good outcomes at 1 year after surgery. Design:  Prospective questionnaire and clinical study. Setting:  Regional Maxillofacial Unit. Participants:  A total of 278 consecutive patients undergoing primary surgery for squamous cell carcinoma between 1995 and 1999. HRQOL was assessed using the University of Washington Quality of Life questionnaire (UW-QOL) pre-surgery, and post-surgery at 6 months, 1 year and later (median 39 months). Main outcome measures:  Presentation of results was mainly descriptive, involving percentages and mean scores. Association of clinico-demographic factors with tumour site, and with UW-QOL swallowing and speech after 12 months, was tested with Fisher's exact or chi-squared tests as appropriate and modelled using logistic regression methods. Results:  Univariate relationships were seen between speech and swallowing scores and with tumour size, T staging, radiotherapy, type of surgery (primary closure or free tissue transfer), tumour site, extent of resection of posterior tongue and soft palate, and UW-QOL taste and saliva scores. Multiple logistic regression showed that no radiotherapy (P < 0.001) and primary surgical closure/laser surgery (P = 0.003) were the main predictors of good swallowing, and primary surgical closure/laser surgery was the main predictor of good speech (P < 0.001) at 1 year. Conclusions:  A number of clinical parameters can influence the speech and swallowing aspect of quality of life in these patients and when feasible, primary closure results in a better outcome than free flap reconstruction.

Item Type: Article
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RK Dentistry
Divisions: Nursing and Midwifery
Date Deposited: 22 Feb 2011 16:47

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