Longitudinal Acoustic Analysis of /s/ in Head and Neck Cancer Patients Treated With Surgery

PURPOSE: Oral and oropharyngeal cancer and its treatment can have a devastating impact on speech. The goal of this study is to characterize the changes in English sibilant /s/ production associated with resection site and the sex and age of the patients following surgical removal of oral and oropharyngeal tumors. METHOD: The acoustics of 4,371 productions of /s/ from read continuous speech of 89 patients (66 men, 23 women) with an mean age of 58.2 years (range: 22-82) were analyzed before and after surgery for oral and/or oropharyngeal cancer. The center of gravity (COG) of the fricative power spectrum was analyzed with a linear mixed-effects model with assessment time (pre-operative and 1, 6, and 12 months postoperative), age, sex, and proportion of resections (%) within oral and pharyngeal structures as fixed effects and random intercepts for speaker and phonetic context. RESULTS: Before surgery, male sex and older age were associated with lower COG. After surgery, COG was reduced with partial recovery at 1 year and dropped more for females than males. Overall, recovery was better among those who did not have radiation. At 1 year, the COG of /s/ was most impacted by resections to the tongue (without radiation), followed by resections to the velopharyngeal mechanism (with radiation). The additional effect of radiation treatment was modulated by age. CONCLUSIONS: The results suggest partial recovery of speech function at 1 year. The recovery was gendered with females remaining further away from the pretreatment values after surgery compared to the males. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.31953024.