Communication difficulties in patients with motor speech disorders due to head and neck cancer at the Uganda Cancer Institute
Abstract
Communication difficulties are common in patients with motor speech disorders resulting from head and neck cancer. Despite the frequency of motor speech disorders secondary to Head and Neck cancer, the effects of these disorders on an individual’s communication and life have been explored by a handful of studies worldwide. Similarly, there's hardly adequate information about communication difficulties in people with motor speech disorders resulting from head and neck cancer in Uganda.
The overall aim of the study was to understand how motor speech disorders due to head and neck cancer affect patient communication, with 3 foci including; i)To profile the motor speech characteristics of patients diagnosed with head and neck cancer. ii)To profile the speech intelligibility of patients diagnosed with head and neck cancer and iii)To determine whether the site of an individual’s tumor determines the impairment they experience in relation to motor speech characteristics and speech intelligibility. A descriptive cross-sectional study was used where 52 participants, 17 females and 35 males of ages between 37 and 82 years completed a self-report questionnaire pertaining to speech intelligibility and motor speech characteristics. Participants included those admitted at the UCI, newly diagnosed with HN cancer, and having motor speech disorders. Motor speech characteristics included; lip function during speech, tongue function during speech, breathe support for speech, nasality of speech, sound of the voice, vocal volume/loudness and overall articulation of speech. Results indicated that individuals with HN cancer had an overall reduction in speech intelligibility and motor speech characteristics with 40% of the participants reporting a reduction in speech intelligibility, 5.77% and 57.69% had reduced lip function and tongue function respectively during speech, 73.07% never had enough breathe support for speech, 42.31% reported changes in nasality of speech, all participants reported a decrease in vocal loudness and changes in the sound of their voices. Participants’ articulation of speech was characterized by misarticulation of back sounds by 42.31% of the participants, middle sounds by 21.15%, front sounds by 9.62%, voiced sounds by 34.62%, and nasal sounds by 42.31% of the participants. These findings accounted for the communication difficulties experienced.
Results further demonstrated that the tumor site dictated the challenges experienced by the individuals with respect to motor speech characteristics and speech intelligibility. All Participants with tumors of the mobile tongue experienced challenges with tongue movements during speech, misarticulated middle sounds and 45% of them misarticulated front sounds unlike participants from other tumor sites. In addition, only participants with tumors of the mobile tongue had challenges with lip movements during speech. All participants with tumors of the nasopharynx and 80% of the soft palate participants had changes in their speech nasality. All soft palate, base of tongue and nasopharynx participants misarticulated back and nasal sounds.
Unlike other tumor sites, almost all (93.73%) of the participants with tumors of the larynx never had enough breathe support during speech. The study highlighted the communication difficulties encountered by HN cancer patients due to motor speech disorders through effects on motor speech characteristics and speech intelligibility.