Practitioners in the field of speech therapy often face challenges when dealing with patients who have undergone tongue reconstruction. The research article titled Speech After Tongue Reconstruction and Use of a Palatal Augmentation Prosthesis: An acoustic case study provides valuable insights that can significantly improve therapy outcomes for these patients. This blog post aims to distill the key findings from this study and suggest ways practitioners can incorporate these findings into their therapeutic practices.
Understanding the Study
The study focused on a 64-year-old female patient who underwent a tongue resection of the anterior two-thirds, followed by a reconstruction using a radial forearm free flap and the use of a palatal augmentation prosthesis (PAP). The acoustic properties of her speech were analyzed at three stages: before the tongue resection, one year after the resection, and two years post-reconstruction while using the PAP.
Key Findings
The study observed acoustic changes in the formant frequencies (F1, F2) of vowels and the spectral moments (mean, skewness) of sibilants (/s/, /z/, /ʃ/). Notably, the use of the PAP resulted in improvements in the production of sibilants /s/ and /z/, although its effect on vowel production was less pronounced.
- **Vowels:** There was an increase in F1 for high vowels (/i/, /u/) when using the PAP, indicating a lower tongue position and narrower pharyngeal area. F2 values for all vowels moved closer to pre-operative levels after using the PAP.
- **Sibilants:** Significant changes were observed in the spectral moments of sibilants. The PAP led to a higher mean energy and lower skewness, suggesting improved tongue-palate contact and more effective articulation.
Practical Implications for Therapists
Based on these findings, here are some practical steps that speech therapists can take to improve therapy outcomes for patients with similar conditions:
- **Monitor Acoustic Changes:** Regularly measure formant frequencies and spectral moments to track the progress of vowel and sibilant production.
- **Use of PAP:** Consider the use of a palatal augmentation prosthesis for patients with significant tongue reconstruction. While the benefits may vary, the PAP has shown potential in improving the articulation of sibilants.
- **Customized Therapy Plans:** Develop individualized therapy plans that focus on the specific acoustic deficits identified in the patient. For instance, if the patient shows reduced tongue-palate contact, exercises to enhance this contact can be beneficial.
- **Collaborative Approach:** Work closely with prosthodontists to design effective PAPs tailored to the patient's unique anatomical and functional needs.
- **Further Research:** Encourage ongoing research and data collection to better understand the long-term effects of PAPs and other prosthetic interventions on speech outcomes.
Conclusion
The research article provides a detailed acoustic analysis that can serve as a valuable resource for speech therapists working with patients who have undergone tongue reconstruction. By integrating these findings into clinical practice, therapists can enhance the effectiveness of their interventions and contribute to the overall improvement of speech outcomes in their patients.
To read the original research paper, please follow this link: Speech After Tongue Reconstruction and Use of a Palatal Augmentation Prosthesis: An acoustic case study.
