This project proposes to continue the study of surgical effects of reconstruction in oral cancer patients begun in the first 5 years of this program project and continued during the second five years. This study examines the effects of surgical reconstructions for oropharyngeal cancer as a first line rehabilitation strategy in oral cancer patients. To date we have collected data on 281 patients and categorized 220 into 25 surgical groups. It is our hypothesis that particular surgical reconstructions can facilitate speech and swallowing or cause a further decrement in function. This project proposes to continue to follow 7 groups of surgically treated oral cancer patients in order to examine the effects of surgical reconstruction on functional outcomes of speech and swallowing. These 7 groups were selected from the original 25 groups studied in the first 10 years of this project to represent the most frequently used resection/reconstruction categories, and those which will enable us to answer the most important research questions. Each patient will be followed for 3 months postoperatively. All patients will be studied preoperatively, and at 1 month and 3 months posthealing. At each of these data collection points, each patient will receive a videofluoroscopic assessment of swallowing and speech, an articulation test, and recording of conversational speech for later intelligibility rating. Functional measures of speech and swallowing will be evaluated within the groups and between groups to define the functional changes effected by each surgical reconstruction and at each tumor site.
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