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Bressman T, Sader R et al. J Oral Maxillofac Surg 2004; 62: 298–303

The removal of part of the tongue is sometimes necessary to treat tumours, but there is considerable variation in the speech outcome. Factors involved may include the amount of tissue removed, the reconstructive technique employed and the degree of tongue motility after surgery. In this study, speech performance was assessed in 14 German patients who had undergone surgery followed by radiotherapy of 60 Gy. Six patients had received platysma flaps in reconstruction.

Sound recordings were made at least 6 months after surgery, and tongue motility was also assessed. Speech intelligibility and acceptability was assessed by 2 raters, who worked blind. The degree of exact agreement on the rating of intelligibility was 85%, and of acceptability, 63%.

Better consonant intelligibility performance was linked to tongue motility (r = 0.62; P < 0.02), as was consonant acceptability (r = 0.74; P < 0.01). There was significantly better intelligibility in 4 patients who retained an intact genioglossus. The authors suggest that this supports the current practice of speech and language pathologists who seek to improve speech in these patients by exercising nonspeech oral motor function.