PTOTSLPCase SeriesDysphagia2022

Speech and Swallowing Outcomes Following Surgical Resection with Immediate Free Tissue Transfer Reconstruction for Advanced Osteoradionecrosis of the Mandible Following Radiation Treatment for Head and Neck Cancer.

Grainne Brady, Lauren Leigh-Doyle, Francesco Mattia Giovanni Riva and 2 others

PMID 34647150

WHAT IT FOUND

In ten patients with severe jaw bone death, surgery and reconstruction left swallowing and speech outcomes split.

Half kept or improved their diet, while half declined. Most speech stayed stable, but two patients became less understandable. Expect mixed functional results.

Key findings

01Half of the patients had stable or improved diet scores at three months, while the other half experienced a decline in diet.

02The majority of patients had stable speech scores, but two patients experienced a deterioration in speech clarity.

03Two patients required supplemental nutrition via a gastrostomy at three months post surgery.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The study included only ten patients from a single centre, which is too small to draw general conclusions about efficacy. No statistical analysis was performed due to the small sample size. Data on previous radiation dosages and other clinical issues like trismus were not available or reported. Instrumental evaluations of swallowing were inconsistently collected. Patient-reported outcome measures were not reported.

Declared interests

None reported.

The easy way to misread this

Do not interpret the mixed outcomes as evidence that this surgery reliably restores normal swallowing or speech. The sample size is extremely small, and half of the patients actually saw their diet tolerance decline, with some requiring tube feeding.

Read it on PubMed →