Obturator prostheses after cancer surgery: an approach to speech outcome assessment.

ABSTRACT

PURPOSE: This article describes a speech assessment protocol for patients using either obturator prostheses or speech aid prostheses for surgically acquired defects due to cancer of the maxilla and/or soft palate. METHODS: This protocol is structured according to the executive summary of "Disability in America Toward a National Agenda For Prevention" a report formulated by the Institute of Medicine that describes four levels of disorder (1) pathology, (2) impairment, (3) functional limitation, and (4) disability. Assessment instruments included (1) the Sentence Intelligibility Test to measure the rate and understandability of speech, (2) a speech physiology system to measure appropriate separation of the nasal/nasopharyngeal and oral compartments, (3) a 13-point interval scale to rate speech nasality, and (4) a scale to rate self-perceptions of communication effectiveness. RESULTS: The results from two patients are reported to illustrate the outcome assessment protocol.