Abstract:
Advanced tongue cancer may have a devastating effect on a person’s ability to speak and to swallow. Very little is
known about the surgical management and speech and swallowing rehabilitation of persons with advanced tongue
cancer in South Africa. The aim of this study was to obtain information regarding clinical practices in treatment and
rehabilitation. Questionnaires were distributed to 450 surgeons and 150 speech-language pathologists in South
Africa. The response rate was 16% for the surgeons and 33% for the speech-language pathologists. Results
showed that only a small number of surgeons and speech-language pathologists in South Africa are involved in the
treatment of persons with advanced tongue cancer. Surgeons prefer combined modality treatment (surgery and
post-operative radiotherapy) in the primary treatment of patients with advanced tongue cancer, but the use of radiochemotherapy
is growing. Total glossectomy is a very radical procedure, but it is sometimes used by surgeons to
treat patients with advanced disease. Total glossectomy with laryngeal preservation is preferred to total glossolaryngectomy
by surgeons, in order to preserve laryngeal voice. Patients with total glossectomy form only a small
part of the caseload of speech-language pathologists. Swallowing rehabilitation includes aspects such as dietary
changes, compensatory swallowing techniques and airway protection mechanisms. Speech intelligibility is targeted
in speech rehabilitation, but alternative communication is sometimes recommended for patients who have undergone
total glosso-laryngectomy.
