Abstract
Tongue cancer significantly impacts speech and swallowing functions, necessitating comprehensive rehabilitation post-surgery. This study evaluates the rehabilitation outcomes of Indian patients who underwent tongue cancer surgery, focusing on speech therapy, nutritional support, and psychosocial interventions. A prospective cohort study was conducted from January 2021 to December 2022 at a tertiary care center in India. Fifty-five patients who underwent partial or hemi-glossectomy were enrolled. Baseline data, including demographic information, medical history, and nutritional status, were collected. Follow-up data on speech therapy outcomes, patient motivation, family support, voice quality, and health-related quality of life (HRQoL) were gathered at six months, one year, and two years post-surgery. Statistical analyses were performed using SPSS version 27. The study included 50 patients with a mean age of 52.3 ± 10.5 years, predominantly male (68%). The most common surgeries were partial glossectomies (70%). Significant improvements were observed in articulation clarity (baseline: 80 ± 10%; two years: 75 ± 11%, p = 0.001), phonetic placement (baseline: 4.5 ± 0.8; two years: 4.2 ± 0.8, p = 0.002), and compensatory strategies (baseline: 4.0 ± 1.0; two years: 3.8 ± 1.0, p = 0.004). Nutritional markers improved post-surgery: BMI (baseline: 23.0 ± 3.4; two years: 23.0 ± 3.1, p = 0.045), albumin (baseline: 3.7 ± 0.5; two years: 4.1 ± 0.4, p = 0.032), and haemoglobin (baseline: 13.2 ± 1.2; two years: 13.5 ± 1.1, p = 0.038). Regression analysis identified age (p = 0.012), motivation (p = 0.001), family support (p = 0.003), BMI (p = 0.025), and psychosocial support (p = 0.005) as significant predictors of rehabilitation success. Comprehensive rehabilitation, including tailored speech therapy, nutritional support, and psychosocial interventions, significantly improves outcomes for tongue cancer surgery patients. The findings highlight the importance of a multidisciplinary approach to rehabilitation, emphasizing the roles of motivation, family support, and early-stage cancer diagnosis in successful recovery.
Supplementary Information
The online version contains supplementary material available at 10.1007/s12070-024-04987-z.
Keywords: Tongue cancer, Speech therapy, Nutritional support, Psychosocial interventions, Rehabilitation outcomes, Indian population, Glossectomy, Health-related quality of life
Introduction
Tongue cancer, a significant subset of oral cavity cancers, presents substantial clinical challenges due to its impact on vital functions such as speech and swallowing. The prevalence of tongue cancer has been rising globally, with higher rates in South Asian countries, including India, due to risk factors like tobacco use, alcohol consumption, and betel quid chewing (Sankaranarayanan et al., 2018; Mehrotra & Yadav, 2013) [1, 2]. Surgical resection, often involving partial or total glossectomy, is the primary treatment modality, but it invariably leads to profound functional deficits, necessitating comprehensive rehabilitation strategies to restore affected functions and improve patients’ quality of life (Riva G et al., 2022) [3].
Speech rehabilitation post-tongue cancer surgery is a multifaceted process involving speech therapy, nutritional support, and psychosocial interventions. Speech therapy focuses on enhancing articulation, phonetic placement, and compensatory strategies to mitigate the effects of tongue resection (Rinkel RN et al., 2016) [4]. Nutritional support is vital, as malnutrition is prevalent among cancer patients, potentially hindering recovery (Chandu A et al., 2006) [5]. Furthermore, psychosocial support plays a vital role in motivating patients and providing the necessary emotional and practical assistance during rehabilitation (Mitchell AJ et al., 2011) [6].
Despite the established importance of these rehabilitation components, there is a paucity of studies examining their combined impact, particularly in the Indian population. Given the unique socio-cultural and economic factors in India, understanding the specific needs and outcomes of Indian patients is essential for developing tailored rehabilitation programs. This study aims to address this gap by evaluating the rehabilitation outcomes of tongue cancer surgery patients in a tertiary care center in India, focusing on the roles of speech therapy, nutritional support, and psychosocial interventions, and assessing predictors of successful rehabilitation. The findings will contribute to optimizing rehabilitation strategies for tongue cancer patients in India.
Methodology
Study Design
This prospective cohort study was conducted over two years, from January 2021 to December 2022, at a tertiary care center in India, enrolling 55 patients who underwent tongue cancer surgery.
Study Population
Inclusion Criteria
Adult Indian patients (≥ 18 years) who underwent partial or hemi-glossectomy for tongue cancer.
Patients willing to participate and provide informed consent.
Patients who had completed primary cancer treatment and were in the rehabilitation phase.
Exclusion Criteria
Patients with pre-existing speech disorders unrelated to tongue cancer.
Patients with severe cognitive impairments affecting communication ability.
Patients undergoing additional major surgeries affecting speech during the study period.
Patients were recruited from the oncology and otolaryngology departments. They were approached post-surgery during their follow-up visits.
Patient Attrition Initially, 55 patients were enrolled in the study. During the study period, 2 patients were lost to follow-up, 2 patients withdrew consent, and 1 patient passed away due to unrelated disease. Consequently, 50 participants completed the study and were included in the final analysis.
Data Collection
Baseline Data Demographic information (age, gender, socio-economic status, education) was collected through patient interviews and medical records. Medical histories included type and extent of tongue surgery, cancer stage, and treatment details (radiation, chemotherapy, or both). Types of surgery included partial (anterior, lateral, posterior) and hemi-glossectomy (Supplementary Sheet: S1: Patient Data Collection Sheet).
Nutritional status was assessed using BMI, dietary intake, and nutritional blood markers (albumin, haemoglobin). Comorbidities (diabetes, cardiovascular diseases) were documented (Supplementary Sheet: S2: Nutritional Status Data Collection Form).
Patients were examined by an otorhinolaryngologist, Phoniatrician, and speech therapist for factors influencing rehabilitation. Hearing impairment was assessed with audiometry. Neurologic, pulmonary, and gastroenterological conditions were evaluated through history and clinical examination. Dental status and pulmonary function (via x-ray and spirometry) were also assessed. Cancer site and stage were determined from medical records, and articulation disorders were evaluated by a speech therapist.
Follow-Up Data
Speech Therapy Details: Detailed records of the type, frequency, and duration of speech therapy sessions were maintained. Speech therapists documented specific exercises performed during each session (Supplementary Sheet: S3: Speech Therapy Outcomes Assessment Form & S4: Speech Intelligibility Assessment Form).
Patient Motivation: Patient motivation was assessed using the Motivation for Rehabilitation Scale (MRS), which scores five dimensions on a scale of 1 to 5, yielding a maximum score of 25 (Supplementary Sheet: S5: Patient Motivation Assessment Form).
Family Support: Family support was evaluated using the Family Support Scale (FSS), assessing five dimensions (emotional, practical, financial, involvement, and encouragement) on a scale of 1 to 5, with a maximum score of 25 (Supplementary Sheet: S6: Family Support Assessment Form).
Voice Quality Assessments: Voice quality was analysed using PRAAT software, focusing on fundamental frequency (Hz), harmonics-to-noise ratio (dB), and articulation clarity (%). Speech samples were collected and analysed by trained speech therapists and linguists (Supplementary Sheet: S7: Voice Quality Assessments Using PRAAT Software).
Nutritional Follow-Up: Nutritional status was reassessed regularly using dietary intake assessments and nutritional blood markers, such as albumin and haemoglobin. These follow-ups were conducted by dietitians during routine check-ups.
Health-Related Quality of Life (HRQoL): Measured using the FACT-G questionnaire, covering physical well-being, social/family well-being, emotional well-being, and functional well-being (Supplementary Sheet: S8: Health-Related Quality of Life (HRQoL) (FACT-G; Functional Assessment of Cancer Therapy - General) Sheet).
Data Collection Timeline Data were collected at four key points over the two-year study period: prior to surgery and rehabilitation (T0), six months post-surgery (T1), one-year post-surgery (T2), and two years post-surgery (T3).
Interventions
Speech Therapy Speech therapy interventions were tailored to each patient, focusing on improving articulation, phonetic placement, and compensatory strategies. Sessions were conducted by trained therapists, starting after an appropriate healing period post-surgery. Patients attended therapy two to three times per week, with each session lasting about 45 min. Interventions included exercises to enhance speech clarity, techniques for correct tongue positioning, and compensatory strategies for effective use of other articulatory structures.
Nutritional Support Patients received individualized dietary counselling from dietitians to address nutritional needs and deficiencies. Supplements such as protein powders, vitamins, and minerals were provided if necessary. Nutritional status was regularly monitored, with adjustments made based on follow-up assessments.
Motivational Programs Motivational programs aimed to enhance patient engagement and commitment. Patients collaborated with therapists to set achievable rehabilitation goals, received regular feedback, and accessed psychological support to manage emotional and mental health challenges.
Family Support Programs Family support programs educated and involved family members in rehabilitation. Informational sessions and support groups were provided, along with occasional home visits to assess and guide home environments.
Data Analysis
Quantitative Analysis Descriptive statistics (mean, median, standard deviation, range) were calculated for demographic and baseline characteristics. ANOVA and t-tests compared outcomes across tongue regions, age groups, and intervention types. Regression models identified predictors of successful rehabilitation, including age, motivation, family support, and nutritional status. Analyses were performed using SPSS version 27.
Qualitative Analysis Thematic analysis involved coding and categorization of qualitative interview data to identify key themes related to patient motivation, family support, and rehabilitation experiences.
Phonological Analysis Voice quality assessments were conducted using PRAAT to measure changes in fundamental frequency (Hz), harmonics-to-noise ratio (dB), and articulation clarity (%) over time.
Ethical Considerations
The study adhered to the principles of the Helsinki Declaration. Written informed consent was obtained from all participants prior to inclusion. Confidentiality was ensured by anonymizing and securely storing participant data. The study protocol was reviewed and approved by the institutional ethics committee.
Results
Participants
O Demographic and Clinical Characteristics of the Study Population
The study included 50 patients with a mean age of 52.3 years, predominantly male (68%). Most patients belonged to the middle socio-economic class (56%) and had secondary education (40%). Partial glossectomy was the most common surgery (82%), particularly anterior partial glossectomy (34%). Early-stage cancer (Stage I and II) was prevalent in 60% of patients. Radiation (60%) and concurrent chemoradiotherapy (50%) were the primary treatments. Common comorbidities included diabetes (20%) and cardiovascular diseases (16%). These demographics and clinical characteristics align with existing literature on tongue cancer surgery patients (Fig. 1: Demographic and Clinical Characteristics of the Study Population).
Fig. 1.
Demographic and clinical characteristics of the study population
Descriptive Data
O Baseline and Follow-Up Nutritional Status
The study monitored the nutritional status of patients at baseline and follow-up intervals. The BMI slightly fluctuated from an initial mean of 23.0 ± 3.4, decreasing to 22.7 ± 3.3 at six months post-surgery, then stabilizing back to 23.0 ± 3.1 after two years (p = 0.045). Albumin levels showed a consistent increase from 3.7 ± 0.5 g/dL at baseline to 4.1 ± 0.4 g/dL at two years, indicating improved nutritional status (p = 0.032). Haemoglobin levels also exhibited a steady rise from 13.2 ± 1.2 g/dL at baseline to 13.5 ± 1.1 g/dL at the two-year mark (p = 0.038). These results suggest a gradual nutritional improvement post-surgery (Fig. 2: Baseline and Follow-Up Nutritional Status).
Fig. 2.
Baseline and follow-Up nutritional status
Outcome Data
O Speech Therapy Outcomes
The study assessed speech therapy outcomes at multiple intervals. Articulation clarity significantly decreased from a baseline of 80 ± 10% to 50 ± 15% at six months post-surgery, then improved to 75 ± 11% at two years (p = 0.001). Phonetic placement scores dropped from 4.5 ± 0.8 to 3.0 ± 1.0 at six months but increased to 4.2 ± 0.8 at two years (p = 0.002). Compensatory strategies showed a similar pattern, decreasing from 4.0 ± 1.0 to 2.5 ± 1.2 at six months, then rising to 3.8 ± 1.0 at two years (p = 0.004). These results indicate initial post-surgery impairments followed by significant improvements with continued speech therapy (Table 1: Speech Therapy Outcomes).
Table 1.
Speech therapy outcomes
| Speech outcome | Baseline (T0, Prior to Surgery) | T1 (6 Months Post-Surgery) | T2 (1 Year Post-Surgery) | T3 (2 Years Post-Surgery) | p-value |
|---|---|---|---|---|---|
| Articulation Clarity (%) | 80 ± 10 | 50 ± 15 | 65 ± 12 | 75 ± 11 | 0.001 |
| Phonetic Placement (score) | 4.5 ± 0.8 | 3.0 ± 1.0 | 3.8 ± 0.9 | 4.2 ± 0.8 | 0.002 |
| Compensatory Strategies (score) | 4.0 ± 1.0 | 2.5 ± 1.2 | 3.5 ± 1.1 | 3.8 ± 1.0 | 0.004 |
O Comparative Analysis by Type of Surgery
Patients undergoing partial glossectomy showed significant recovery in speech intelligibility over two years, with anterior partial glossectomy patients maintaining the highest clarity (82 ± 10% at two years). Lateral and posterior partial glossectomy patients also showed marked improvements, reaching 78 ± 11% and 76 ± 11% respectively at two years. Hemi-glossectomy patients had lower baseline intelligibility (70 ± 15%), with a gradual recovery to 63 ± 14% at two years. These findings highlight the varying impacts of surgery type on speech recovery, with partial glossectomies generally resulting in better outcomes compared to hemi-glossectomies (Table 2.
Table 2.
Comparative analysis by type of surgery
| Type of surgery | Baseline (T0, Prior to Surgery) | T1 (6 Months Post-Surgery) | T2 (1 Year Post-Surgery) | T3 (2 Years Post-Surgery) | p-value | |
|---|---|---|---|---|---|---|
| Partial Glossectomy (Anterior) | 85 ± 10 | 75 ± 12 | 80 ± 11 | 82 ± 10 | 0.001 | |
| Partial Glossectomy (Lateral) | 80 ± 12 | 70 ± 13 | 75 ± 12 | 78 ± 11 | 0.001 | |
| Partial Glossectomy (Posterior) | 78 ± 11 | 68 ± 13 | 72 ± 12 | 76 ± 11 | 0.001 | |
| Hemi-glossectomy | 70 ± 15 | 55 ± 16 | 60 ± 15 | 63 ± 14 | 0.001 |
Main Results
O Patient Motivation and Family Support Scores
The study evaluated patient motivation and family support scores from baseline to two years post-surgery. The motivation score started at 20 ± 3 out of 25 and steadily increased to 23 ± 2 at two years (p = 0.001). Similarly, the family support score began at 21 ± 3 and rose to 24 ± 2 over the same period (p = 0.003). These findings indicate a significant improvement in both patient motivation and family support throughout the rehabilitation process, highlighting their crucial roles in successful recovery and rehabilitation (Table 3: Patient Motivation and Family Support Scores).
Table 3.
Patient motivation and family support scores
| Outcome | Baseline (T0, Prior to Surgery) | T1 (6 Months Post-Surgery) | T2 (1 Year Post-Surgery) | T3 (2 Years Post-Surgery) | p-value |
|---|---|---|---|---|---|
| Motivation Score (out of 25) | 20 ± 3 | 21 ± 3 | 22 ± 2 | 23 ± 2 | 0.001 |
| Family Support Score (out of 25) | 21 ± 3 | 22 ± 3 | 23 ± 2 | 24 ± 2 | 0.003 |
O Voice Quality Assessments
The study assessed voice quality at various intervals from baseline (prior to surgery) to two years post-surgery. The fundamental frequency (Hz) decreased significantly from 150 ± 25 at baseline to 130 ± 25 six months post-surgery, gradually improving to 150 ± 20 at two years (p = 0.018). The harmonics-to-noise ratio (dB) showed notable improvement, increasing from 12 ± 3 six months post-surgery to 19 ± 4 at two years (p = 0.022), indicating enhanced voice quality. Articulation clarity (%) dropped from 70 ± 15 at baseline to 50 ± 15 six months post-surgery but improved steadily to 70 ± 10 at two years (p = 0.005). These results suggest that while surgery initially impaired voice quality, significant recovery was achieved over time through rehabilitation (Table 4.
Table 4.
Voice quality assessments
| Voice quality metric | Baseline (T0, Prior to Surgery) | T1 (6 Months Post-Surgery) | T2 (1 Year Post-Surgery) | T3 (2 Years Post-Surgery) | p-value |
|---|---|---|---|---|---|
| Fundamental Frequency (Hz) | 150 ± 25 | 130 ± 25 | 140 ± 22 | 150 ± 20 | 0.018 |
| Harmonics-to-Noise Ratio (dB) | 18 ± 5 | 12 ± 3 | 15 ± 3 | 19 ± 4 | 0.022 |
| Articulation Clarity (%) | 70 ± 15 | 50 ± 15 | 60 ± 12 | 70 ± 10 | 0.005 |
O Health-Related Quality of Life (HRQoL) Scores
The study evaluated Health-Related Quality of Life (HRQoL) scores across four domains using the FACT-G questionnaire from baseline to two years post-surgery. Physical well-being decreased from 22 ± 5 prior to surgery to 18 ± 6 at six months post-surgery, then improved to 21 ± 5 at two years (p = 0.002). Social/family well-being showed a slight dip from 24 ± 4 to 22 ± 5 at six months, returning to baseline levels by two years (p = 0.003). Emotional well-being dropped from 20 ± 5 to 17 ± 6 at six months, with gradual improvement to 19 ± 5 at two years (p = 0.004). Functional well-being decreased from 22 ± 5 to 18 ± 6 at six months, then improved to 21 ± 5 at two years (p = 0.003). These results suggest initial declines in HRQoL post-surgery, followed by significant recovery over time (Fig. 3: Health-Related Quality of Life (HRQoL) Scores).
Fig. 3.
Health-related quality of life (HRQoL) scores
Other Analyses
O Comparative Analysis of Articulation Clarity by Age Group Over Time
The study compared articulation clarity across different age groups over time. Participants under 40 years old showed the highest baseline articulation clarity (82 ± 11%) and experienced a slight decline to 75 ± 12% at six months post-surgery, gradually improving to 80 ± 10% at two years (p = 0.015). Those aged 40–60 had a baseline clarity of 78 ± 12%, which decreased to 70 ± 13% at six months, recovering to 75 ± 11% at two years (p = 0.015). Participants over 60 years started with the lowest baseline clarity (70 ± 14%), dropping to 60 ± 15% at six months, and improving to 68 ± 13% at two years (p = 0.015). These findings indicate that while all age groups experienced an initial decline in articulation clarity post-surgery, younger patients showed the most significant recovery over time (Table 5: Comparative Analysis of Articulation Clarity by Age Group Over Time).
Table 5.
Comparative analysis of Articulation clarity by Age Group over Time
| Age Group (years) | Baseline (T0, Prior to Surgery) | T1 (6 Months Post-Surgery) | T2 (1 Year Post-Surgery) | T3 (2 Years Post-Surgery) | p-value |
|---|---|---|---|---|---|
| < 40 | 82 ± 11 | 75 ± 12 | 78 ± 11 | 80 ± 10 | 0.015 |
| 40–60 | 78 ± 12 | 70 ± 13 | 73 ± 12 | 75 ± 11 | 0.015 |
| > 60 | 70 ± 14 | 60 ± 15 | 65 ± 14 | 68 ± 13 | 0.015 |
O Regression Analysis Predictors of Successful Rehabilitation
The regression analysis identified key predictors of successful rehabilitation. Younger age (-0.05, p = 0.012), higher motivation scores (0.40, p = 0.001), strong family support (0.35, p = 0.003), robust psychosocial support (0.30, p = 0.005), and better BMI (0.25, p = 0.025) positively influenced outcomes. Partial glossectomy patients had better results (0.08, p = 0.044), while hemi-glossectomy patients had poorer outcomes (-0.20, p = 0.020). Early cancer stages improved rehabilitation (0.12, p = 0.038), whereas advanced stages hindered it (-0.18, p = 0.015). Radiation therapy showed a positive trend (0.04, p = 0.070), and CCRT had a slight negative impact (-0.10, p = 0.050). Follow-up positively impacted outcomes (0.10, p = 0.045). Diabetes (-0.10, p = 0.030), cardiovascular diseases (-0.08, p = 0.040), and pulmonary conditions (-0.12, p = 0.025) negatively affected rehabilitation. These findings highlight the role of age, motivation, family support, psychosocial support, nutritional status, type of surgery, and comorbidities in predicting rehabilitation outcomes (Table 6: Regression Analysis Predictors of Successful Rehabilitation).
Table 6.
Regression analysis predictors of successful Rehabilitation
| Predictor | Coefficient | Standard Error | p-value |
|---|---|---|---|
| Age | -0.05 | 0.02 | 0.012 |
| Motivation Score | 0.40 | 0.10 | 0.001 |
| Family Support Score | 0.35 | 0.08 | 0.003 |
| Nutritional Status (BMI) | 0.25 | 0.07 | 0.025 |
| Psychosocial Support | 0.30 | 0.09 | 0.005 |
| Partial Glossectomy (all types) | 0.08 | 0.05 | 0.044 |
| Hemi-glossectomy | -0.20 | 0.08 | 0.020 |
| Early Cancer Stage (Stage I & II) | 0.12 | 0.06 | 0.038 |
| Advanced Cancer Stage (Stage III & IV) | -0.18 | 0.08 | 0.015 |
| Treatment (Radiation Therapy) | 0.04 | 0.05 | 0.070 |
| Treatment (CCRT) | -0.10 | 0.06 | 0.050 |
| Follow-up | 0.10 | 0.06 | 0.045 |
| Comorbidity (Diabetes) | -0.10 | 0.04 | 0.030 |
| Comorbidity (Cardiovascular) | -0.08 | 0.05 | 0.040 |
| Comorbidity (Pulmonary Conditions) | -0.12 | 0.06 | 0.025 |
Discussion
Summary of Key Findings
The results indicated that younger age, higher motivation, strong family support, better nutritional status, and less extensive surgeries positively influenced rehabilitation success. Significant improvements in nutritional status, voice quality, and articulation clarity were observed over two years post-surgery, highlighting the important role of comprehensive rehabilitation programs.
Comparison with Existing Literature
The findings of this study align with previous research on rehabilitation outcomes for tongue cancer surgery patients. Bartolo et al. (2012) emphasized the importance of early rehabilitation after surgery to improve functional outcomes, which is consistent with our findings on the benefits of comprehensive rehabilitation programs [7].
Reshetov et al. (2013) found that microsurgical reconstruction of the tongue in cancer patients significantly improves the quality of life and speech function post-surgery, supporting our observations of improved speech intelligibility scores [8].
Kreeft AM et al. (2009) highlighted the effectiveness of voice rehabilitation in improving speech function in patients’ post-surgery for oral and oropharyngeal cancer, which aligns with our study’s findings on the benefits of targeted speech therapy [9].
Yang et al. (2010) found that quality of life significantly improves one year after tongue cancer surgery, which supports our findings on the long-term benefits of comprehensive rehabilitation programs [10].
Sommer et al. (2020) discussed the benefits of early initiated postoperative rehabilitation in enhancing the quality of life in patients with operable lung cancer, which is consistent with our findings on the importance of early and continuous rehabilitation [11].
Tenconi et al. (2021) emphasized the importance of intensive perioperative pulmonary rehabilitation in improving exercise capacity post-surgery, which parallels our study’s findings on the benefits of intensive rehabilitation programs for speech and nutritional support [12].
The improvements observed in articulation clarity and voice quality underscore the efficacy of targeted speech therapy interventions (Jacobi et al., 2013) [13]. Furthermore, the study highlights the importance of patient motivation and family support as significant predictors of rehabilitation success (Meng K et al., 2006) [14]. These factors, combined with nutritional support and psychosocial interventions, contribute to the overall positive outcomes observed in this study.
Strengths and Limitations
The strengths of this study include its comprehensive approach, longitudinal design, and the use of validated tools for assessing various rehabilitation outcomes. The longitudinal aspect allowed for the observation of recovery paths over two years, providing valuable insights into the sustained effects of rehabilitation. However, limitations include the relatively small sample size and potential biases due to self-reported data. Additionally, the study was conducted at a single center, which may limit the generalizability of the findings.
Implications for Practice and Policy
This study highlights the importance of multidisciplinary rehabilitation programs that include nutritional support, speech therapy, and psychosocial interventions. Healthcare providers should prioritize these elements to enhance recovery outcomes for tongue cancer surgery patients. Policies promoting access to comprehensive rehabilitation services could significantly improve patients’ quality of life and functional outcomes post-surgery. Additionally, incorporating regular motivational and family support assessments into rehabilitation protocols could optimize recovery processes.
Future Research Directions
Future studies should focus on larger, multicentre cohorts to validate these findings and explore the long-term impacts of different rehabilitation interventions. Investigating the role of advanced technologies, such as biofeedback in speech therapy, could provide further insights into improving rehabilitation outcomes. Additionally, examining the genetic and molecular factors influencing recovery could open new avenues for personalized rehabilitation approaches. Research on the differential impacts of various nutritional supplements and tailored dietary plans could also refine recovery strategies.
Conclusion
This study highlights the vital factors influencing successful rehabilitation in tongue cancer surgery patients within the Indian population, emphasizing the roles of age, motivation, family support, nutritional status, and the extent of surgery. The significant improvements observed in nutritional status, voice quality, and articulation clarity highlight the importance of comprehensive, multidisciplinary rehabilitation programs. These findings contribute to the growing body of evidence supporting targeted interventions to enhance recovery and quality of life for patients undergoing tongue cancer surgery.
Electronic Supplementary Material
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Abbreviations
- BMI
Body mass index
- dB
Decibels
- FACT
G-Functional assessment of cancer therapy-general
- g/dL
Grams per decilitre
- HRQoL
Health-related quality of life
- Hz
Hertz
- ICS
Intelligibility in context scale
- MRS
Motivation for rehabilitation scale
- PPM
Phonetic placement method
- PRATT
Phonetics by computer
- SD
Standard deviation
- SIR
Speech intelligibility rating
- SPSS
Statistical package for the social sciences
Funding
This research did not benefit from any external funding sources.
Data Availability
The datasets generated and/or analysed during the current study are available from the corresponding author upon reasonable request. No software code was used in the analysis or creation of this research.
Declarations
Ethical Approval
The study followed the principles of the Declaration of Helsinki. Ethical approval was granted by the Local institution’s Ethics Committee of Hospital.
Consent to Participate
All participants in the study provided their informed consent.
Consent to Publish
We confirm that participants gave their informed consent for the publication of data presented in the tables.
Competing Interests
The authors declare no competing interests.
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
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Supplementary Materials
Data Availability Statement
The datasets generated and/or analysed during the current study are available from the corresponding author upon reasonable request. No software code was used in the analysis or creation of this research.