This project is designed to apply information on functional changes after treatment for oropharyngeal cancer, gathered in previous years of this study, in development of patient education materials for pre- and post-operative counselling, and in the design and conduct of a speech pathology/maxillofacial prosthetic/nutritional rehabilitation program, and a study of three methods of provision of psychosocial support during the patient's first year post-surgery. Patient education materials will be developed in the first year of the study with application and evaluation in the second and third years. A co-ordinated speech/prosthetic/nutritional rehabilitation program will be initiated in year one of the study with the goal of rapid rehabilitation of 63 surgically treated oral cancer patients, including 21 patients in each of three surgical categories. Co-ordinated rehabilitation will be initiated prior to treatment with planning of interventions including a palatal reshaping prosthesis, and patient counselling. The palatal reshaping prosthesis will be provided when oral feeding is initiated. Speech and swallowing therapy and nutritional counselling will begin with the prosthesis in place, and will continue for three months post-surgery. Each patient's function will be assessed clinically by the dietitian, speech pathologist and prosthodontist at monthly intervals with palate reshaping modified as the patient's function dictates. Detailed studies of each patient's vocal tract control, including evaluation of oral and pharyngeal function during swallowing and speech, will be completed at the time of initiation of oral feeding after surgery, and 1, 3, 6 and 12 months later. Functional patterns of patients receiving the program at each interval post-treatment will be compared with similar data available from previous studies on patient function patterns without the program. Results will also be compared between surgical groups. The 63 patients will also be included in a randomized study of three methods of provison of psychosocial support during the first year post-treatment. The impact of each psychosocial support program will be evaluated with measures of consistency of each patient's speech and swallowing function, and socialization over the first year post-treatment.
| Logemann, J A (1985) Aspiration in head and neck surgical patients. Ann Otol Rhinol Laryngol 94:373-6 |
