Journal of Shanghai Jiao Tong University (Medical Science) ›› 2022, Vol. 42 ›› Issue (12): 1720-1728.doi: 10.3969/j.issn.1674-8115.2022.12.010
• Evidence-based medicine • Previous Articles
WU Mei1(
), LIANG Yanjing1, HOU Lili2()
Received:2022-05-20
Accepted:2022-11-28
Online:2022-12-28
Published:2022-12-28
Contact:
HOU Lili
E-mail:583512378@qq.com;pisces_liz@163.com
Supported by:CLC Number:
WU Mei, LIANG Yanjing, HOU Lili. Evaluation tools for speech function after oral cancer surgery: a scoping review[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(12): 1720-1728.
Add to citation manager EndNote|Ris|BibTeX
URL: https://xuebao.shsmu.edu.cn/EN/10.3969/j.issn.1674-8115.2022.12.010
Fig 1 Flow chart of literature selection
| Authour | Year | Nation | Subjects | Objective | Design | Sample size |
|---|---|---|---|---|---|---|
WOISARD， et al［ | 2022 | France | Patients with oropharyngeal or oral cancer who are in the "chronic" stage （i.e.， having completed treatment at least 6 months ago） and are in clinical remission， ensuring that the speech impairment is as stable as possible. The control group consisted of the patients' companion to be close to the subjects in terms of age， lifestyle， and location | Through acoustic parameters， an automatic speech severity index model suitable for clinical practice is established to help predict the degree of speech impairment | Cross-sectional studies | 87 vs 35 |
DOKHE， et al［ | 2021 | India | Patients after oral cancer surgery | It aims to develop a speech intelligibility tool that can perceive and analyze Malayalam | Cross-sectional studies | 120 |
| KEILMANN，et al［ | 2021 | Germany | Survivors of oral cancer （floor of the mouth，tongue，palatine tonsils，base of tongue， palate， jaw， oropharynx， nasopharynx or cheek） who have undergone surgery | To build a simplified assessment tool for measuring the subjective experience of dysphonia | Cross-sectional studies | 113 |
| KEILMANN，et al［ | 2016 | Germany | Patients with treated head and neck tumors.Treatment includes radiotherapy，chemotherapy， immunotherapy and surgery. Head and neck tumors include tumors of the floor of the mouth， tongue， palate， tonsils， base of tongue， maxilla， jaw， oropharynx， nasopharynx and cheeks | To develop the AHI scale and do its psychometric analysis | Cross-sectional studies | 113 |
RIEMANN， et al［ | 2015 | Germany | Patients with squamous cell carcinoma of the tongue who have undergone surgery | Through the automatic objective speech recognition system， prospective speech intelligibility evaluation was carried out for patients with postoperative oral squamous cell carcinoma | Cohort studies | 25 vs 40 |
| ELLABBAN，et al［ | 2012 | Egypt | Patients with squamous cell carcinoma of the floor of the mouth who have undergone surgery | Oral function was reported by using a FIGS scale to determine the patient's ability to speak， chew， and swallow after surgical treatment for squamous cell carcinoma of the floor of the mouth | Cohort studies | 62 |
RINKEL， et al［ | 2008 | Netherlands | Oral or pharyngeal cancer that has been treated， including chemotherapy， radiation and surgery | A SHI scale was developed for 92 patients with oral or pharyngeal cancer and 110 healthy patients | Cross-sectional studies | 92 vs 110 |
| NISHIGAWA， et al［ | 2003 | Japan | Patients with maxillary defects after oral cancer surgery | To develop a new method to use galvanic skin response as an indicator of satisfaction with pronunciation function | Cross-sectional studies | 11 |
| LIST， et al［ | 1990 | America | Patients with head and neck tumors | To develop a simple， practical assessment tool to measure function in patients with head and neck tumors in a standard and systematic way | Cross-sectional studies | 181 |
Tab 1 Characteristics of the included studies
| Authour | Year | Nation | Subjects | Objective | Design | Sample size |
|---|---|---|---|---|---|---|
WOISARD， et al［ | 2022 | France | Patients with oropharyngeal or oral cancer who are in the "chronic" stage （i.e.， having completed treatment at least 6 months ago） and are in clinical remission， ensuring that the speech impairment is as stable as possible. The control group consisted of the patients' companion to be close to the subjects in terms of age， lifestyle， and location | Through acoustic parameters， an automatic speech severity index model suitable for clinical practice is established to help predict the degree of speech impairment | Cross-sectional studies | 87 vs 35 |
DOKHE， et al［ | 2021 | India | Patients after oral cancer surgery | It aims to develop a speech intelligibility tool that can perceive and analyze Malayalam | Cross-sectional studies | 120 |
| KEILMANN，et al［ | 2021 | Germany | Survivors of oral cancer （floor of the mouth，tongue，palatine tonsils，base of tongue， palate， jaw， oropharynx， nasopharynx or cheek） who have undergone surgery | To build a simplified assessment tool for measuring the subjective experience of dysphonia | Cross-sectional studies | 113 |
| KEILMANN，et al［ | 2016 | Germany | Patients with treated head and neck tumors.Treatment includes radiotherapy，chemotherapy， immunotherapy and surgery. Head and neck tumors include tumors of the floor of the mouth， tongue， palate， tonsils， base of tongue， maxilla， jaw， oropharynx， nasopharynx and cheeks | To develop the AHI scale and do its psychometric analysis | Cross-sectional studies | 113 |
RIEMANN， et al［ | 2015 | Germany | Patients with squamous cell carcinoma of the tongue who have undergone surgery | Through the automatic objective speech recognition system， prospective speech intelligibility evaluation was carried out for patients with postoperative oral squamous cell carcinoma | Cohort studies | 25 vs 40 |
| ELLABBAN，et al［ | 2012 | Egypt | Patients with squamous cell carcinoma of the floor of the mouth who have undergone surgery | Oral function was reported by using a FIGS scale to determine the patient's ability to speak， chew， and swallow after surgical treatment for squamous cell carcinoma of the floor of the mouth | Cohort studies | 62 |
RINKEL， et al［ | 2008 | Netherlands | Oral or pharyngeal cancer that has been treated， including chemotherapy， radiation and surgery | A SHI scale was developed for 92 patients with oral or pharyngeal cancer and 110 healthy patients | Cross-sectional studies | 92 vs 110 |
| NISHIGAWA， et al［ | 2003 | Japan | Patients with maxillary defects after oral cancer surgery | To develop a new method to use galvanic skin response as an indicator of satisfaction with pronunciation function | Cross-sectional studies | 11 |
| LIST， et al［ | 1990 | America | Patients with head and neck tumors | To develop a simple， practical assessment tool to measure function in patients with head and neck tumors in a standard and systematic way | Cross-sectional studies | 181 |
| Author | Speech-related assessment methods | Purpose of assessment | How to measure results | Key results of the study |
|---|---|---|---|---|
| WOISARD， et al［ | ① SHI ② PHI ③ SLP ④ ASR Systems： openSMILE 3.0， PRAAT 6.1， VOCALAB 4 | ①SHI is used to assess the degree of speech impairment ②PHI is used to assess the degree of sound impairment ③SLP assesses speech comprehension ④ASR is used to measure speech intelligibility | Eighty-seven patients were treated for oral or oropharyngeal cancer and 35 controls performed different speech-producing tasks and completed questionnaires about speech-related quality of life. The recordings were then evaluated by human perception and automatic speech recognition. A score was derived from a classical Logistic regression model that can describe the severity of the patient's speech disorder | After using three software programs for acoustic treatment， 6 parameters were derived to help predict speech disorders in the future， and the assessment was automated and more reproducible than from manual evaluation |
| DOKHE， et al［ | ASIAT | ASIAT is used for perceptual analysis of speech functions to obtain speech intelligibility and comprehensibility | Internal consistency and reliability and validity tests | The scale has high internal consistency， with Cronbach's α of 0.847， a strong correlation between Malayalam and English， and a Pearson correlation coefficient of 0.646 |
| KEILMANN，et al［ | ① AHI ② Short form AHI-12 | AHI-12 is used to assess the degree of dysphonia | Reliability and validity test | The short form AHS-12 questionnaire provides almost as much information as AHI， and it takes significantly less time to complete it. Optimal with 12 entries， Cronbach's α is 0.96 |
| KEILMANN，et al［ | ①AHI ②Self-assessment | AHI is used to assess the degree of dysphonia | Cronbach's α values for the AHI scale's item total correlation， principal component analysis， and outcome component. To test its validity， the relationship between AHI and self-evaluation was applied to Kendall's tau values between AHI scores and self-assessments | AHI is one-dimensional， so only a full Cronbach's α coefficient was measured， and Cronbach's α coefficient was 0.96. The AHI score and Kendall's tau value between the self-rating and the self-rating were 0.69 （P< 0.001） |
| RIEMANN，et al［ | ASR systems PEAKS （programme for evaluation and analysis for all types speech disorders） | ASR is used to measure speech intelligibility and word recognition rate | Patients were evaluated before surgery， 14‒20 d after surgery， 3 months， 6 months and 12 months after surgery， and the cumulative speech function evaluation results of patients were obtained， and then compared between groups | At 12 months before and after surgery， patients developed significant language impairment compared with healthy controls （P≤0.002）. Speech intelligibility decreased significantly 14 to 20 d after surgery （P<0.001）， but was readjusted to preoperative levels after 12 months （P=0.159）. After 12 months， tongue retention significantly improved speech intelligibility （P=0.007） |
| ELLABBAN，et al［ | FIGS | FIGS is used to assess intraoral function and includes three dimensions： swallowing， speech， and chewing | Patient scoring data were collected preoperatively， 2， 6 and 12 months postoperatively to obtain trends in FIGS scores | The mean baseline speech score was 4.9 points， which decreased to 4.1 points two months after surgery. At 6 and 12 months after surgery， the mean speech score increased to 4.2 and 4.3 at the same time. FIGS is a simple and comprehensive way to assess functional impairment in postoperative patients |
RINKEL， et al［ | ① SHI ② EORTC QLQ-H&N35 ③The control group was asked if they had a question about speaking （answered "yes" or "no"） | ①SHI is used to assess the degree of speech impairment ②EORTC QLQ-H&N35 is used to assess quality of life in patients with head and neck tumors， including the dimension of speech function | The reliability of the SHI scale was assessed by using internal consistency （Cronbach's α） and retesting stability （Pearson's r）. | The internal consistency reliability （Cronbach's α coefficient） for the SHI total score was 0.98 in the patient group and 0.92 in the control group， and the Pearson's r coefficients for the total score and subscale were 5.85， 0.83， and 0.72， respectively. The correlation （Pearson's r coefficients） between the SHI Total Score， the SHI Verbal Function Subscale， the SHI Psychosocial Function Subscale， and the EORTC QLQ-H & N35 Speech Scale （Pearson's r coefficients） were 0.86， 0.81， and 0.84， respectively |
| NISHIGAWA，et al［ | ① Speech intelligibility test （assessed by SLP） ② VAS ③ GSR measuring instrument | ① VAS is used in patients to self-assess the degree of speech impairment ② GSR judges speech function through the results of the electric skin response | The results of galvanic skin reactions before and after the prostheses were compared | The mean rate of decline in articulation resistance in patients with prostheses was significantly smaller than the value without prostheses， and the results were statistically different （P<0.05）， suggesting that wearing prostheses helped with pronunciation |
| LIST，et al［ | PSS-HN | It is used to evaluate postoperative dietary function， speech comprehension and eating in public in patients with head and neck tumors | Reliability and validity test | The degree of agreement between rater scores was described by using κ statistics，κ = 0.88 ［standard error （SE） = 0.08］ for a normal diet； Speech comprehensibility κ = 0.64 （SE = 0.12）； Eating in public， κ = 0.78 （SE = 0.11）. Kruskal-Wallis statistics showed that the difference between groups was significant on all three subscales （P < 0.05） |
Tab 2 Evaluation tools of speech function after oral cancer surgery
| Author | Speech-related assessment methods | Purpose of assessment | How to measure results | Key results of the study |
|---|---|---|---|---|
| WOISARD， et al［ | ① SHI ② PHI ③ SLP ④ ASR Systems： openSMILE 3.0， PRAAT 6.1， VOCALAB 4 | ①SHI is used to assess the degree of speech impairment ②PHI is used to assess the degree of sound impairment ③SLP assesses speech comprehension ④ASR is used to measure speech intelligibility | Eighty-seven patients were treated for oral or oropharyngeal cancer and 35 controls performed different speech-producing tasks and completed questionnaires about speech-related quality of life. The recordings were then evaluated by human perception and automatic speech recognition. A score was derived from a classical Logistic regression model that can describe the severity of the patient's speech disorder | After using three software programs for acoustic treatment， 6 parameters were derived to help predict speech disorders in the future， and the assessment was automated and more reproducible than from manual evaluation |
| DOKHE， et al［ | ASIAT | ASIAT is used for perceptual analysis of speech functions to obtain speech intelligibility and comprehensibility | Internal consistency and reliability and validity tests | The scale has high internal consistency， with Cronbach's α of 0.847， a strong correlation between Malayalam and English， and a Pearson correlation coefficient of 0.646 |
| KEILMANN，et al［ | ① AHI ② Short form AHI-12 | AHI-12 is used to assess the degree of dysphonia | Reliability and validity test | The short form AHS-12 questionnaire provides almost as much information as AHI， and it takes significantly less time to complete it. Optimal with 12 entries， Cronbach's α is 0.96 |
| KEILMANN，et al［ | ①AHI ②Self-assessment | AHI is used to assess the degree of dysphonia | Cronbach's α values for the AHI scale's item total correlation， principal component analysis， and outcome component. To test its validity， the relationship between AHI and self-evaluation was applied to Kendall's tau values between AHI scores and self-assessments | AHI is one-dimensional， so only a full Cronbach's α coefficient was measured， and Cronbach's α coefficient was 0.96. The AHI score and Kendall's tau value between the self-rating and the self-rating were 0.69 （P< 0.001） |
| RIEMANN，et al［ | ASR systems PEAKS （programme for evaluation and analysis for all types speech disorders） | ASR is used to measure speech intelligibility and word recognition rate | Patients were evaluated before surgery， 14‒20 d after surgery， 3 months， 6 months and 12 months after surgery， and the cumulative speech function evaluation results of patients were obtained， and then compared between groups | At 12 months before and after surgery， patients developed significant language impairment compared with healthy controls （P≤0.002）. Speech intelligibility decreased significantly 14 to 20 d after surgery （P<0.001）， but was readjusted to preoperative levels after 12 months （P=0.159）. After 12 months， tongue retention significantly improved speech intelligibility （P=0.007） |
| ELLABBAN，et al［ | FIGS | FIGS is used to assess intraoral function and includes three dimensions： swallowing， speech， and chewing | Patient scoring data were collected preoperatively， 2， 6 and 12 months postoperatively to obtain trends in FIGS scores | The mean baseline speech score was 4.9 points， which decreased to 4.1 points two months after surgery. At 6 and 12 months after surgery， the mean speech score increased to 4.2 and 4.3 at the same time. FIGS is a simple and comprehensive way to assess functional impairment in postoperative patients |
RINKEL， et al［ | ① SHI ② EORTC QLQ-H&N35 ③The control group was asked if they had a question about speaking （answered "yes" or "no"） | ①SHI is used to assess the degree of speech impairment ②EORTC QLQ-H&N35 is used to assess quality of life in patients with head and neck tumors， including the dimension of speech function | The reliability of the SHI scale was assessed by using internal consistency （Cronbach's α） and retesting stability （Pearson's r）. | The internal consistency reliability （Cronbach's α coefficient） for the SHI total score was 0.98 in the patient group and 0.92 in the control group， and the Pearson's r coefficients for the total score and subscale were 5.85， 0.83， and 0.72， respectively. The correlation （Pearson's r coefficients） between the SHI Total Score， the SHI Verbal Function Subscale， the SHI Psychosocial Function Subscale， and the EORTC QLQ-H & N35 Speech Scale （Pearson's r coefficients） were 0.86， 0.81， and 0.84， respectively |
| NISHIGAWA，et al［ | ① Speech intelligibility test （assessed by SLP） ② VAS ③ GSR measuring instrument | ① VAS is used in patients to self-assess the degree of speech impairment ② GSR judges speech function through the results of the electric skin response | The results of galvanic skin reactions before and after the prostheses were compared | The mean rate of decline in articulation resistance in patients with prostheses was significantly smaller than the value without prostheses， and the results were statistically different （P<0.05）， suggesting that wearing prostheses helped with pronunciation |
| LIST，et al［ | PSS-HN | It is used to evaluate postoperative dietary function， speech comprehension and eating in public in patients with head and neck tumors | Reliability and validity test | The degree of agreement between rater scores was described by using κ statistics，κ = 0.88 ［standard error （SE） = 0.08］ for a normal diet； Speech comprehensibility κ = 0.64 （SE = 0.12）； Eating in public， κ = 0.78 （SE = 0.11）. Kruskal-Wallis statistics showed that the difference between groups was significant on all three subscales （P < 0.05） |
| 1 | 李江, 张春叶. 口腔癌及口咽癌病理诊断规范[J]. 中国口腔颌面外科杂志, 2020, 18(4): 289-296. |
| LI J, ZHANG C Y.Pathological diagnosis of oral cancer and oropharyngeal cancer[J].Chin J Stomatol, 2020(3): 145-152. | |
| 2 | BRAY F, FERLAY J, SOERJOMATARAM I, et al. Global cancer statistics 2018: globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424. |
| 3 | FENG R M, ZONG Y N, CAO S M, et al. Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics? [J]. Cancer Commun, 2019, 39(1): 22. |
| 4 | 郑家伟, 李金忠, 钟来平, 等. 口腔鳞状细胞癌临床流行病学研究现状[J]. 中国口腔颌面外科杂志, 2007, 5(2): 83-90. |
| ZHENG J W, LI J Z, ZHONG L P, et al. Clinical epidemiological research status of oral squamous cell carcinoma[J]. China J Oral Maxillofac Surg, 2007, 5(2):83-90. | |
| 5 | 中华口腔医学会口腔颌面外科专业委员会肿瘤学组. 口腔颌面部恶性肿瘤治疗指南[J]. 中国口腔颌面外科杂志, 2010, 8(2): 98-106. |
| Oncology Group, Oral and Maxillofacial Surgery Committee, Chinese Stomatology Association. Guidelines for the treatment of oral and maxillofacial malignancies[J]. China J Oral Maxillofac Surg, 2010, 8(2): 98-106. | |
| 6 | JOO Y H, CHO J K, Koo B S, et al. Guidelines for the surgical management of oral cancer: Korean society of thyroid-head and neck surgery[J]. Clin Exp Otorhinolaryngol, 2019, 12(2): 107-144. |
| 7 | LAM L, SAMMAN N. Speech and swallowing following tongue cancer surgery and free flap reconstruction: a systematic review[J]. Oral Oncol, 2013, 49(6): 507-524. |
| 8 | OMURA K. Current status of oral cancer treatment strategies: surgical treatments for oral squamous cell carcinoma[J]. Int J Clin Oncol, 2014, 19(3): 423-430. |
| 9 | 何三纲. 口腔解剖生理学[M]. 8版. 北京: 人民卫生出版社, 2020: 257-260. |
| HE S G. Oral anatomy and physiology[M]. 8th ed. Beijing: People's Medical Publishing House, 2020: 257-260. | |
| 10 | FOSTER C C, MELOTEK J M, BRISSON R J, et al. Definitive chemoradiation for locally-advanced oral cavity cancer: a 20-year experience[J]. Oral Oncol, 2018, 80: 16-22. |
| 11 | BLYTH K M, MCCABE P, MADILL C, et al. Speech and swallow rehabilitation following partial glossectomy: a systematic review[J]. Int J Speech Lang Pathol, 2015, 17(4): 401-410. |
| 12 | 彭翠娥, 李赞, 周波, 等. 口腔癌术后患者症状群与生活质量的相关性研究[J]. 中华现代护理杂志, 2020, 26(8): 1038-1043. |
| PENG C E, LI Z, ZHOU B, et al. A study on the correlation between symptom groups and quality of life in patients after oral cancer surgery[J].Chin J Modern Nurs, 2020, 26(8): 1038-1043. | |
| 13 | LOCKWOOD C, DOS SANTOS K B, PAP R. Practical guidance for knowledge synthesis: scoping review methods[J]. Asian Nurs Res (Korean Soc Nurs Sci), 2019, 13(5): 287-294. |
| 14 | WOISARD V, BALAGUER M, FREDOUILLE C, et al. Construction of an automatic score for the evaluation of speech disorders among patients treated for a cancer of the oral cavity or the oropharynx: the Carcinologic Speech Severity Index[J]. Head Neck, 2022, 44(1): 71-88. |
| 15 | DOKHE Y, THANKAPPAN K, SOOD R, et al. Validation of an intelligibility assessment tool in an Indian language for perceptual speech analysis in oral cancer patients[J]. Indian J Surg Oncol, 2021, 12(1): 100-107. |
| 16 | KEILMANN A, KONERDING U, OBERHERR C, et al. The Articulation Handicap Scale with 12 items (AHS-12): a short form of the Articulation Handicap Index (AHI)[J]. Logoped Phoniatr Vocol, 2021, 46(2): 70-76. |
| 17 | KEILMANN A, KONERDING U, OBERHERR C, et al. Articulation handicap index: an instrument for quantifying psychosocial consequences of impaired articulation[J]. Eur Arch Otorhinolaryngol, 2016, 273(12): 4493-4500. |
| 18 | RIEMANN M, KNIPFER C, ROHDE M, et al. Oral squamous cell carcinoma of the tongue: prospective and objective speech evaluation of patients undergoing surgical therapy[J]. Head Neck, 2016, 38(7): 993-1001. |
| 19 | ELLABBAN M A, SHOAIB T, DEVINE J, et al. The functional intraoral Glasgow scale in floor of mouth carcinoma: longitudinal assessment of 62 consecutive patients[J]. Eur Arch Otorhinolaryngol, 2013, 270(3): 1055-1066. |
| 20 | RINKEL R N, VERDONCK-DE LEEUW I M, VAN REIJ E J, et al. Speech Handicap Index in patients with oral and pharyngeal cancer: better understanding of patients' complaints[J]. Head Neck, 2008, 30(7): 868-874. |
| 21 | NISHIGAWA G, NATSUAKI N, MARUO Y, et al. Galvanic skin response of oral cancer patients during speech[J]. J Oral Rehabil, 2003, 30(5): 522-525. |
| 22 | LIST M A, RITTER-STERR C, LANSKY S B. A performance status scale for head and neck cancer patients[J]. Cancer, 1990, 66(3): 564-569. |
| 23 | NG E, LAW T, TANG E C H, et al. The cutoff point and diagnostic accuracy of the voice handicap index in Cantonese-speaking population[J]. J Voice, 2021, 35(2): 163-168. |
| 24 | CHAN H F, NG M L, ROSEN C A, et al. Cultural adaptation and validation of speech handicap index: a scoping review[J]. Am J Speech Lang Pathol, 2021, 30(2): 748-760. |
| 25 | 吴沛霞, 姚晴, 王韦, 等. 中文版言语障碍指数量表的信效度评价[J]. 护理学杂志, 2014, 29(18): 28-31. |
| WU P X, YAO Q, WANG W, et al. Evaluation of the reliability and validity of the Chinese version of the Speech Handicap Index Scale[J]. J Nurs Sci, 2014, 29(18): 28-31. | |
| 26 | CHAN H F, NG M L, ROSEN C A, et al. Cultural adaptation and validation of speech handicap index: a scoping review[J]. Am J Speech Lang Pathol, 2021, 30(2): 748-760. |
| 27 | FICHAUX-BOURIN P, WOISARD V, GRAND S, et al. Validation of a self assessment for speech disorders (Phonation Handicap Index)[J]. Rev Laryngol Otol Rhinol (Bord), 2009, 130(1): 45-51. |
| 28 | GOLDIE S J, JACKSON M S, SOUTAR D S, et al. The functional intraoral Glasgow scale (FIGS) in retromolar trigone cancer patients[J]. J Plast Reconstr Aesthet Surg, 2006, 59(7): 743-746. |
| 29 | BALAGUER M, POMMÉE T, FARINAS J, et al. Effects of oral and oropharyngeal cancer on speech intelligibility using acoustic analysis: systematic review[J]. Head Neck, 2020, 42(1): 111-130. |
| 30 | RINKEL R N P M, VERDONCK-DE LEEUW I M, BREE R, et al. Validity of patient-reported swallowing and speech outcomes in relation to objectively measured oral function among patients treated for oral or oropharyngeal cancer[J]. Dysphagia, 2015, 30(2): 196-204. |
| 31 | CONSTANTINESCU G, RIEGER J, WINGET M, et al. Patient perception of speech outcomes: the relationship between clinical measures and self-perception of speech function following surgical treatment for oral cancer[J]. Am J Speech Lang Pathol, 2017, 26(2): 241-247. |
| 32 | BECK-BROICHSITTER B E, HUCK J, KÜCHLER T, et al. Self-perception versus professional assessment of functional outcome after ablative surgery in patients with oral cancer[J]. J Cancer Res Clin Oncol, 2017, 143(2): 305-311. |
| [1] | SHEN Yan, ZHANG Hong. Qualitative research of survival experience of liver transplant recipients [J]. , 2013, 33(5): 556-. |
| Viewed | ||||||
|
Full text |
|
|||||
|
Abstract |
|
|||||
