Speech and voice outcomes in oropharyngeal cancer and evaluation of the University of Washington Quality of Life speech domain

Thomas, L, Jones, T M, Tandon, S, Carding, P, Lowe, D and Rogers, Simon (2009) Speech and voice outcomes in oropharyngeal cancer and evaluation of the University of Washington Quality of Life speech domain. Clinical Otolaryngology, 34 (1). pp. 34-42. ISSN 1749-4478 DOI https://doi.org/10.1111/j.1749-4486.2008.01830.x

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Abstract

BACKGROUND: Radical treatment of oropharyngeal cancer can have significant impact on speech & voice outcomes. AIMS: (i) To assess the extent of speech & voice handicap in disease-free survivors of oropharyngeal squamous cell cancer. (ii) To assess the validity of the speech domain of UWQOL as a screening tool. (iii) To identify clinical characteristics associated with worse speech/voice outcome. DESIGN:Cross-sectional survey. SETTING:University Hospital Aintree, a university teaching hospital and tertiary referral centre. PATIENTS:All who were treated for oropharyngeal cancer between 1 January 1999 and 31 May 2005, were alive, disease free and willing to participate. INTERVENTIONS:Three patient-based questionnaires: University of Washington Quality of Life (UWQOL), voice handicap index (VHI) and voice related quality of life (VRQOL). Three expert-based assessments: GRBAS rating, speech intelligibility and dysarthria rating. RESULTS:Sixty-six per cent of patients participated. Median VHI score (29) & VRQOL score (15) imply mild to moderate voice impairment. 20% of patients had severe handicap (VHI score >60). Forty-eight per cent had normal voice ratings. Speech was normal in 26%, mildly impaired in 62% and significantly impaired in 12% patients (UWQOL). Correlation between UW-QOL speech domain with speech intelligibility rating was 0.52 (P < 0.001). There were clear demarcations between UW-QOL scores of 30, 70 and 100 on the voice questionnaires. Adverse speech and voice function were associated with tumour stage, radiotherapy (RT) & free-flap surgery. CONCLUSIONS:Voice & speech impairment is prevalent in >70% of oropharyngeal cancer patients. There is moderate correlation between UWQOL speech domain and speech intelligibility assessment & voice tools making it a quick and easy screening instrument. The main clinical correlates associated with adverse patient and observer rated speech and voice outcomes were tumour stage, RT and free-flap reconstruction.

Item Type: Article
Subjects: R Medicine > RT Nursing
Divisions: Nursing and Midwifery
Date Deposited: 23 Apr 2012 11:17
URI: http://repository.edgehill.ac.uk/id/eprint/3832

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