Postoperative Quality Of Life Evaluation Of Patients With Tongue Carcinoma And Preliminary Study Of Speech Function Assessment Methods

Objective:To evaluate quality of life with different questionnaires and investigate related influencing factors within patients with tongue carcinoma and hope to find a reliable questionnaire to assess the postoperative quality of life of patients with tongue carcinoma. To study the speech function if patients with tongue carcinoma and find the correlation between articulation level and frequency analysis.Methods:We retrospectively studied127cases of patients with tongue carcinoma treated in Nanjing Stomatological Hospital from January2011to August2012, their clinical manifestation were recorded and arrayed. University of Washington quality of life questionnaire (UW-QOL), Performance status scale for head and neck cancer patients (PSS-HN), Karnofsky Performance Scale (KPS) and Visual Analogue Scale (VAS) were completed together with patients and clinicians. Patients were recorded reading Chinese Articulation Level Test by VS-9700. Recording materials were analyzed and rated by two non-professional judges.20college students were also recorded as the control group. Top ten characters that had been pronounced incorrectly were selected, of which formant frequencies were analyzed.Results:"Mood" score of female group was significantly different from that of male group (p<0.05). Scores in "mood","activity" and "recreation" of mandible-un-reserved group had a great difference with that of mandible-reserved group (p<0.01). Swallow" score of fascio-cutaneous flap group was significantly different from that of myocutaneous flap group. Scores of radiotherapy group in "swallow","saliva" and "total" were lower than those of control group, and significant differences were shown. No significant difference was seen between those groups divided by the sizes of tongue defects while some differences were shown in those groups divided by the locations of tongue defects.UW-QOL questionnaire has more symptom-related entries than PSS-HN questionnaire, in which,"swallow","speech" and total scores of UW-QOL were significantly related to "diet","speech intelligibility" and total scores of PSS-HN. Total score of UW-QOL was significant relevant to that of KPS. No notable relevance was found between VAS score and articulation level of these patients.Conclusions:Continuity of mandible, clinical stage and radiotherapy were main factors influencing postoperative quality of life. There is no specific questionnaire designed for assessing quality of life of patients with tongue carcinoma. Compared to PSS-HN and KPS, UW-QOL is a more thorough and more suitable questionnaire to evaluate the quality of life of patients with tongue carcinoma. Chinese Articulation Level Test is a subjective test, a reviewing standard is needed. VAS could be used as a visual scale to rate the satisfaction level of postoperative tongue appearance. There seemed little connection between appearance satisfaction and speech function. Evaluating speech function simply via frequency analysis may be unilateral.