This document discusses the acoustic characteristics of speech for individuals who have undergone a glossectomy or partial removal of the tongue. It notes that a glossectomy is commonly performed to treat tongue cancer. For a patient who underwent a right hemiglossectomy, an articulation test in Hindi revealed distortions of affricates, fricatives, and dental/retroflex stops, with poor intelligibility. Acoustic analysis found deviated pitch, intensity, and noise parameters in the voice, as well as deviated average formant values, due to changes in oral cavity volume from the surgery. Rehabilitation of swallowing and speech therapy are important for socialization following a glossectomy.

1. ACOUSTIC CHARACHTERISTICS OF
GLOSSECTOMEE’S SPEECH
Himani Bansal
Students of BASLP,
ENT department, Netaji Subhash Chandra Bose Medical College,
Jabalpur, Madhya Pradesh

2.  The tongue is a fairly large muscular organ in the
mouth. The tongue has two parts: the oral tongue and
the base of the tongue.
 It has a significant role in normal oral functions of
articulation, chewing and swallowing.

3.  A glossectomy is the removal of all or part of the tongue
 According to the National Cancer Institute’s database, it
is estimated that 12,770 men and women will be
diagnosed with tongue cancer in 2012. The median age
of diagnosis of tongue cancer over the last few years
was 61 years of age. It is more common in men than in
women.

4.  A glossectomy is performed mainly for cancers of the
tongue. However, cancers from other parts of the
mouth and throat that grow to involve the tongue may
require a glossectomy, especially floor of mouth
cancers.

5. Glossectomy
Partial
glossectomy: any part
of the tongue, side or
tip, an entire half of the
tongue or even more.
Total
glossectomy: This is
the removal of the
entire tongue, including
the base of the tongue.

6.  Articulation-the movement of the tongue,
lips, jaw, and other speech organs to make
speech sounds
 Tongue- Major articulator
 Acoustic characteristics
 Dysphagia

15. NAME : XXX
AGE/GENDER : 48 years / female
ADDRESS: REWA , MP
REFERRED FROM: Cancer dept.

16.  unclear speech
 Difficulty in swallowing after glossectomy
 Invasive grave II squamous cell carcinoma
 Right hemiglossectomy with selective neck dissection
done on 24 nov 2016

17. PROVISIONAL DIAGNOSIS
DYSPHAGIA WITH MISARTICULATION SECONDARY TO GLOSSECTOMY
RECOMMENDATIONS
 Swallowing therapy
 Speech therapy
 Follow up

18. Hindi Articulation Test
 HINDI ARTICULATION TEST

PHONEME INITIAL MEDIAL FINAL
/a/ P P
/a:/ P P P
/i/ P P P
/i:/ P P P
/u/ P P P
/u:/ P P P
/e/ P P
/ᵆ/ P
/o/ P P
/au/ P

19. PHONEME INITIAL MEDIAL FINAL
/k/ distorted - -
/kh/ P P P
/g/ P P -
/gh/ P P -
/c/ D D -
/ch/ D D -
/dz/ D D D
/dzh/ D - -
/t./ D D D
/d./ D D D
/dh./ D
/t/ D D D
/th/ D - -
/d/ D - -
/dh/ D - -

20. PHONEME INITIAL MEDIAL FINAL
/n/ P P P
/p/ P P -
/ph/ P - -
/b/ P P P
/bh/ P
/m/ P P P
/j/ P P P
/r/ D D D
/l/ P P P
/v/ P - -
/ᶴ/ P - P
/s/ P P -
/h/ P P -

21. •Bilabial , liquids , glides and velar stop are produced
correctly [both in isolation and word level ]
•Distortion of affricates , fricates , dental and retroflex stop
observed.
•Intelligibility is poor. [ scored 1 in a 4 point rating scale ].

22.  Difficulty in chewing solid food
 The client is under liquid and semi solid diet
 Difficulty to produce lingual sounds
 Mild nasality observed
 Pocketing of oral cavity

23.  Excessive saliva production. she is aware of it
and wipe it accordingly
 Differentially taste [ hot and cold also
 Difficulty to make bolus
 Restricted movement of residual tongue.

24.  Voice evaluation using Vaghmi (Version 4.1) indicated of
reduced range of pitch and intensity.
 Rate of fluctuations and extent of fluctuations was
affected.
 Noise parameters including jitter percentage and
shimmer percentage, Relative Average
Perturbations(RAP-3cycles), Relative Average
Perturbations(RAP- 5) and Periodic Voice Index(PVI)
are noticed to be deviated from normative.

25.  Praat (Version 5.3.01) revealed deviated average formant
values for corner vowels.
 These variations can be explained as a property of
changes of volume of front and back cavity.

26.  After surgery voice quality & resonance are
compromised because of changes in oral cavity
volume, and articulation is affected because the tongue
is unable to assume the normal position to provide
valuing action needed for precise articulation.
 Rehabilitation of swallowing also plays an important
role in socialization. Speech therapy to improve the
speech & deglutition of glossectomy patient is essential.
 Perceptual, acoustical and physiological assessment –
for better decision- treatment

27. Thank you