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

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Abstract:

Clin. Otolaryngol. 2005, 30, 428–437 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.

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-2273.2005.01061.x

Affiliations: 1: Speech and Language Therapy Department, University Hospital Aintree, Aintree Hospitals NHS Trust, Liverpool 2: Mossley, Cheshire 3: Regional Maxillofacial Unit, University Hospital Aintree, Aintree Hospitals NHS Trust, Liverpool, UK

Publication date: October 1, 2005

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