Source: Arch Otolaryngol Head Neck Surg. 2008;134(12):1299-1304
Authors: Maria-Mercedes Suarez-Cunqueiro, DDS, PhD et al.

Objectives:
To assess the prevalence of speech and swallowing impairment after radical surgery for oral and oropharyngeal cancer from the patient’s viewpoint and to examine the association of these functional alterations with selected clinical characteristics regarding patients, tumors, and oncologic treatment.

Design:
Cross-sectional, multicenter study using a self-administered questionnaire.

Setting:
Forty-three hospitals in Germany, Switzerland, and Austria.

Patients:
A total of 3894 questionnaires about rehabilitation problems after treatment for oral and oropharyngeal squamous cell carcinoma were sent to patients. Of these, 1652 were filled out and returned, and 1334 (80.8%) met the inclusion criteria.

Main Outcome Measures:
Morbidity associated with treatment of oral and oropharyngeal cancer.

Results:
Speech problems were reported by 851 patients (63.8%), and swallowing problems were reported by 1006 patients (75.4%). The variables that presented a significant association with speech and swallowing impairment were sex, tumor location, pTNM stages, stage of tumor, treatment modality, and reconstruction type.

Conclusions:
This survey, based on patient perception, suggests that those who undergo radiotherapy associated with the surgical removal of a tumor, have late-stage tumors (III-IV), or have tumors located in the floor of the mouth should be informed of the greater risk of persistent severe speech and swallowing problems.

Authors:
Maria-Mercedes Suarez-Cunqueiro, DDS, PhD; Alexander Schramm, DDS, MD, PhD; Ralf Schoen, DDS, MD, PhD; Juan Seoane-Lestón, DDS, MD, PhD; Xosé-Luis Otero-Cepeda, PhD; Kai-Hendrik Bormann, DDS; Horst Kokemueller, MD, DDS; Marc Metzger, MD, DDS; Pedro Diz-Dios, DDS, MD, PhD; Nils-Claudius Gellrich, DDS, MD, PhD

Author Affiliations:
Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany (Drs Suarez-Cunqueiro, Bormann, Kokemueller, and Gellrich); Department of Oral and Maxillofacial Surgery, German Federal Armed Forces Hospital, Ulm, Germany (Dr Schramm); Departments of Stomatology (Drs Suarez-Cunqueiro, Seoane-Lestón, and Diz-Dios) and Biostatistics (Dr Otero-Cepeda), University Santiago de Compostela, Santiago de Compostela, Spain; and Department of Oral and Maxillofacial Surgery, University Hospital Freiburg, Albert-Ludwigs-University, Freiburg, Germany (Drs Schoen and Metzger).