Evaluation of Speech in Patients with Partial Surgically Acquired Defects

Introduction: Maxillectomy often results in disabilities such as inability to masticate, deglutition and speech disturbance. Unfortunately, little is known about the nature of the speech disturbance and the influence of the class of surgical defect in this group of patients. Objectives: The aim is to assess the effectiveness of the maxillary obturator as a speech rehabilitation aid and the influence of the classes of surgical defects on speech intelligibility (SI). Methods: Twelve patients aged between 18 and 60 years with surgically acquired partial maxillary defects were included in this study. The patients were given immediate surgical obturators 6-10 days after surgery, which were converted to interim obturators which were used for 2-3 months after which the definitive obturators were fabricated. The speech intelligibility test described by Plank et al and Wheeler et al was employed in this study. Results: There were significant improvement in the mean speech intelligibility scores from 59.8% without prosthetic obturation to 89.2% following interim obturation and 94.7% following definitive obturation (p<0.005). Nine patients (75%) had class I surgical defect, 2 (16.67%) had class II defect while only 1 patient (8.33%) had class VI surgical defect. None of the patients had Class III, IV or Class V surgical defect. There was an improvement in the speech intelligibility score from class 1 to class VI without obturation, after insertion of interim obturator and after insertion of definitive obturator. Conclusion: Maxillary obturator seems to be a useful speech rehabilitation aid. It also showed that immediate, interim and definitive obturators are all important in the speech rehabilitation of patients with surgically acquired maxillary defects. Moreover speech intelligibility is affected by the class of defect.