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ABSTRACT Background Acoustic evaluation of speech is the least explored method of speech evaluation in patients with oral cavity and oropharyngeal cancer. The purpose of this study was to explore acoustic parameters of speech and their correlation with questionnaire evaluation and perceptual evaluation in patients with oral cavity and oropharyngeal cancer. Methods One hundred seventeen subjects (65 consecutive patients with oral cavity and oropharyngeal cancer and 52 controls) participated in this study. Formant frequencies (by Linear Predictive Coding), Speech Handicap Index, and London Speech Evaluation scale were used for acoustic evaluation, questionnaire evaluation, and perceptual evaluation, respectively. Results Men showed significant elevation in second formant (F2) values for patients with oral cavity cancer and those who underwent surgery alone. Female patients with early T classification cancers and those who underwent surgery and chemoradiation showed significant reduction in the mean F2 values. Importantly, however, acoustic evaluation parameters did not correlate with either perceptual evaluation or questionnaire evaluation parameters, although there was moderate correlation between questionnaire evaluation and perceptual evaluation speech parameters. Conclusion Acoustic evaluation modalities have no clear role in the management of patients with oral cavity and oropharyngeal cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: 670-676, 2016 [ABSTRACT FROM AUTHOR]

Background Carcinoma is a rare complication of pharyngeal diverticula. There is a paucity of information about its incidence, presentation, management, and treatment outcomes. A systematic review and analysis of all reported cases has been carried out. Methods A comprehensive literature search for pharyngeal diverticula carcinoma was performed from 1896 to 2008. Descriptive analyses were carried out by analyzing the absolute and relative frequencies. Comparison of groups was illustrated with Kaplan-Meier curves and tested statistically using the log-rank test. A cohort of 56 patients with benign pharyngeal diverticula was selected for comparison with the accumulated cohort of pharyngeal diverticula carcinoma, and a Fisher's exact test was carried out on the extracted clinical characteristics of this cohort to evaluate for differences between benign and malignant pharyngeal diverticula. Results Forty-three articles reporting 60 cases satisfied the inclusion criteria. The mean age at presentation was 68.8 years (SD = 9.8 years). Five-year cancer-specific survival (CSS) rates for patients who underwent excision alone, excision + postoperative radiotherapy (PORT), and radiotherapy alone were 0.74 versus 0.63 versus 0.0, respectively ( p = .39). Five-year CSS rates of patients <65 versus ≥65 years were 0.43 versus 0.78, respectively ( p = .046). Conclusion Irregular symptoms in benign diverticula should raise suspicion of malignancy. Management consists of surgical excision ± PORT. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1368-1375, 2014 [ABSTRACT FROM AUTHOR]

Background The aim of this study was to develop and validate the first ever speech-specific perceptual speech-evaluation tool for patients with head and neck cancer. Methods Five speech parameters (intelligibility, articulation, speech rate, nasality, and asthenia) and overall grade were included and evaluated. Speech samples of 117 subjects were recorded on electroglottograph equipment using a standard protocol and were independently judged and rated by 3 experienced speech and language therapists and re-rated 12 weeks apart. Results Among patients the Cronbach's alpha (α) coefficients for internal consistency for connected speech were 0.89, whereas for single words the α coefficients ranged between 0.80 and 0.84. The Spearman's correlation coefficients for intra-rater reliability for connected speech and words varied between 0.30 and 0.90 and 0.49 and 0.76, respectively, whereas for inter-rater reliability the coefficients ranged between 0.53 and 0.99 and 0.56 and 0.99, respectively. For construct validity, the Spearman's correlation coefficient ranged between 0.41 and 0.55. Conclusions The London Speech Evaluation (LSE) scale demonstrated a high reliability and validity in our cohort of patients with head and neck cancer. surgery. © 2011 Wiley Periodicals, Inc. Head Neck, 2012 [ABSTRACT FROM AUTHOR]

Background. Posttreatment speech problems are seen in nearly half of patients with head and neck cancer. Although there are many voice-specific scales, surprisingly there is no speech-specific questionnaire for English-speaking patients with head and neck cancer. The aim of this study was to validate the Speech Handicap Index (SHI) as the first speech-specific questionnaire in the English language. Method. In all, 55 consecutive patients in follow-up for oral and oropharyngeal cancer completed the SHI and University of Washington Quality of Life Questionnaire (UWQOL V.04). Thirty-two patients completed both questionnaires again 4 weeks later to address test-retest reliability. Results. Internal consistency, test-retest reliability, construct validity, and group validity of the SHI were found to be highly significant (p < .01) using Cronbach's alpha, Spearman's correlation coefficient (r), and Mann-Whitney U tests. Conclusions. The SHI is a precise, highly reliable, and valid speech assessment tool for patients with head and neck cancer. Further dedicated studies using the SHI in patients with head and neck cancer would be useful. [ABSTRACT FROM AUTHOR]

Aims: To compare voice quality as defined by formant analysis using a sustained vowel in patients who have undergone a partial glossectomy with a group of normal subjects. Methods & Procedures: The design consisted of a single centre, cross-sectional cohort study. The setting was an Adult Tertiary Referral Unit. A total of 26 patients (19 males) who underwent partial glossectomy and 31 normal volunteers (18 males) participated in the study. Group comparisons using the first three formant frequencies (F1, F2 and F3) using linear predictive coding (Laryngograph Ltd, London, UK) were performed. The existence of any significant difference of F1, F2 and F3 between the two groups using the sustained vowel /i/ and the effects of other factors, namely age, first presentation versus recurrence, site (oral cavity, oropharynx), subsite (anterior two-thirds of the tongue, tongue base), stage, radiation, complication, and neck dissection, were analysed. Outcomes & Results: Formant frequencies F1, F2 and F3 were normally distributed. F1 and F2 were significantly different in normal males versus females. F1, F2 and F3 were not different statistically between male and female glossectomees. Comparison of only women showed significant differences between normal subjects and patients in F2 and F3, but none in F1. This was the opposite in men where F1 was significantly different. Age, tumour presentation, site, subsite, radiation and neck dissection showed no significant difference. Postoperative complications significantly affected the F1 formant frequency. Conclusions: The study found that the formant values in patients following a partial glossectomy were altered significantly as compared with the normal control subjects. Only gender and complications and not the age, site, subsite, radiation and neck dissection were seen to influence the formant scores. [ABSTRACT FROM AUTHOR]

The article offers information on effective treatment protocols for human papillomavirus (HPV)-related oral cavity (OC) and oropharyngeal cancer (OPC). It mentions that HPV is a sexually transmitted infection, and changing of sexual practices that may increase the effect of HPV infection on the development of OPCs in younger adults. Moreover, radiotherapy (RT) group is treated with RT and surgery and will receive post-operative RT (PORT) while the non-RT group only treated with surgery alone.

The article focuses on the speech and voice rehabilitation of post laryngectomy. It notes that voice restoration through voice prosthesis is based on the surgical establishment of a tracheoesophageal puncture maintained by silicon one-way valve. It points out that successful alaryngeal speakers' voice restoration can be obtained with electrolarynx, esophageal speech, or tracheoesophageal (TE).

Objectives: To conduct a multifactorial analysis of patients with oral cavity and oropharyngeal squamous cell carcinoma surgically treated at the Royal Marsden Hospital.Methods: This is a 20-year retrospective analysis (1983–2003) with reference to site, age, gender, surgical approach, survival, etc.Results: There were 306 patients (251 fresh and 55 recurrent cases) with oral cavity and oropharyngeal squamous cell carcinomas (oral cavity, 203; oropharynx, 100; unknown, 3). Of these, 202 patients were male and 104 were female (M:F = 1.9:1) patients. Mean age at diagnosis was 57 years. The subsite distribution was as follows: oral cavity, T-125, BM-39, FOM-39; oropharynx, LW-65, AW-23, PW-6, and SW-6. An external surgical approach was performed in 196 cases and a peroral approach in 120 cases. A mandibulectomy was done in 47 cases (hemimandibulectomy, 27; segmental mandibulectomy, 9; and marginal mandibulectomy, 11) and glossectomy in 129 patients (partial, 71; hemi, 37; subtotal, 3; and total, 18). Two hundred eleven patients were subjected to radiotherapy (radical, 113; postop, 93; palliative, 5, and iridium implants, 4). Locoregional recurrence occurred in 95 patients with distant metastasis in 20 patients. Overall cause-specific survival at 1, 3, and 5 years was 86%, 66%, and 61%, respectively.Conclusions: Minimizing morbidity while ensuring good oncologic tissue margins with any approach to the oral cavity and oropharynx is difficult, but it is imperative. When factors were considered singly, poor prognosis was associated with late stage postop radiotherapy and external surgical approach. The effect of metastasis during follow-up was associated with a poor prognosis for survival. Nodal status and age were not significant predictors of survival. [Copyright &y& Elsevier]