First report on the reliability and validity of speech handicap index in ...

Introduction:
Head and neck cancer per se and its treatment may negatively affect patient's functional
status and quality of life. 1-6
Patients often <strong>report</strong> speech deterioration, swallowing
difficulties and facial appearance changes which may ultimately result in psycho-social
problems. 7-10 Nowhere else is this more obvious than in cancers involving the oral cavity
and oropharynx. 1,2 The presence of post-treatment speech problems in patients with oral
and oropharyngeal cancers has been well documented in the literature by both
prospective and retrospective studies. 11-29 According to recent estimates, nearly 50% of
oral and oropharyngeal cancer patients encounter speech problems in their day-to-day
life, 2 which is not surprising as the tumor and its treatment often has a detrimental impact
on the functioning of important speech articulators (tongue, alveolar ridge, hard and soft
palate and floor of mouth) in the oral cavity and the oropharynx. 1 Timely detection of
post-treatment speech problems and their appropriate rehabilitation is vital in providing a
good functional QOL to these patients. 1,13
Evaluation of patient’s speech can be undertaken by either subjective methods or
objective speech analysis techniques. 1,30 Easiest and most commonly used methods are
subjective speech evaluation by using patient self-rated health-related QOL
questionnaires (HRQOL). 1,31 These can be general, disease-specific or
symptom/function-specific QOL questionnaires. 1,31 To date, there are over 1000
instruments available for measuring health-related QOL in patients. 31 Some commonly
used head-neck cancer -specific questionnaires are University of Washington QOL
(UWQOL), European Organization for Research and Treatment of Cancer head-neck
3