Card Set Information

2010-05-09 14:04:01

Mod 23 Speech problems in Glossectomy and Related disorders
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  1. 6 most common sites of tumors in the oral cavity and oropharynx?
    • Hard palate
    • Soft palate
    • Alvelus lateral floor of mouth, tonsil, and anterior faucial pillar
    • lateral tongue margin
    • base of tongue
    • Alveolar ridge
  2. Surgical resection of oral cavity tumors:

    resection takes?

    Simple resection removes/involves?

    Composite resection removes/involves?
    tumor + a margin of 1.5-2 cm normal tissue

    only one structure

    • more than one structure
    • -usually invoves FOM +_ mandible
  3. Oral ablative reconstruction surgeries

    Primary closure
    Used to?
    ___ pulled together/sutured?
    • close small wounds
    • residual soft tissues
  4. Oral ablative reconstruction surgeries

    Flap or graft:
    Used in?
    Not enough __ for primary closure?
    • larger wounds
    • residual tissue
  5. Speech intelligibility following glossectomy is related to? (7)
    • amount of tongue removed
    • mobility of residual tongue
    • status of dentition/remaining teeth
    • type of reconstruction
    • Also:
    • hearing
    • general health
    • motivation
  6. Speech problems: 2 problems
    • articulation
    • resonance
  7. Speech problems: Articulation
    Impaired tongue results?
    __ english consonants require tongue contact are?
    impaired speech articulation

    • 15:
    • linguapalatal contact /t,d,n,l/ /s,z, sh, ge/ /ch, dge/ /k,g,ng/

    linguadental /th/
  8. speech problems: resonance
    depends on ?
    Surgical alterations in ____ all affect speech resonance, oral and nasal?
    oral cavity shape, size, tissue tonicity

    vocal tract shape, size, tonicity
  9. Speech Tx in glossectomy
    ___ involved in all phases pre-post surgery?

    Post-op speech assessment can take place ?


    as soon as suture lines adequately healed to withstand ROM exercises ~7-14th day

    • Determine the potential for "acceptable approximations" to target sounds, not to obtain normal speech
    • Is the person a candidate for prothesis
    • Provide specific recommendations for speech therapy
  10. Speech Tx in glossectomy should include evaluation of? (8)
    • Oral structures
    • ROM of tongue and mandible
    • Tongue strength
    • Oral sensation
    • Articulation
    • Ability to use compensatory gestures (adaptive)
    • Resonance
    • Intelligibility
  11. Speech Therapy:
    Pts with 50% or more residual tongue, can start ?
    Pts with <50% residual tongue and/or severe mobility problems, ___ is indicated; ___ is deferred?
    ROM exercises


    ROM exercises
  12. Speech Therapy:

    ROM exercises (depend on extent of impairment)
    • vertical/up-down movements
    • anterior-posterior movements
    • lateral/horizontal movements
    • mandibular movements NB for radiation rx pts.
  13. Speech Tx:
    Exercises to increase tongue strength in tip & dorsum

    Frequency and duration?
    tongue blade during protrusion, lateralization, elevation

    2 to 3 minutes 5 to 10 times daily
  14. Intraoral prothesis: palatal lowering/reshaping
    Also called?

    Purpose is to ?

    Can be constructed and placed in about ___ after healing is complete?

    palatal augmentation appliances

    to facilitate tongue contact with hard palate for speech, mastication, swallowing

    4-6 weeks

    as soon as possible to avoid maladaptive speech compensations
  15. Effects of radiation Tx in head & neck pts: (
    Xerostomia, edema, sores

    • tooth decay
    • jaw stiffness
    • sore mouth or throat
    • changes in voice
    • denture problems
    • changes in sense of taste or smell
    • changes in thyroid; fatigue; weight gain

    changes occur gradually
  16. ___: reduced saliva/dry mouth; can cause
  17. ___ shoud begin before radiation tx begins and may need to continue forever to avoid or minimize fibrosis?
    ROM exercises for jaw, tongue & larynx