Predictors of Speech Quality after Tongue Cancer Surgery

舌癌手术后言语质量的预测因素

基本信息

批准号：
8467993
负责人：
MAUREEN STONE
金额：
$ 46.26万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-05-12 至 2015-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8467993
关键词：
Acoustics Address Affect Anatomy Area Articular Range of Motion Atlases Behavior Cancer Patient Cancerous Characteristics Cicatrix Cine Magnetic Resonance Imaging Communication Computers Conscious Consensus Data Diagnostic Neoplasm Staging Diffusion Magnetic Resonance Imaging Dimensions Discipline Distal Excision Exhibits Fatigue Feeling Fiber Forearm Gestures Glossectomy Head Cancer Healed Health Image Incidence Individual Inferior Knowledge Left Life Link Location Magnetic Resonance Imaging Malignant Neoplasms Maps Measurement Measures Mechanics Mediating Mental Depression Methods Modeling Modification Morphology Motion Muscle Neck Cancer Neoplasm Metastasis Noise Operative Surgical Procedures Outcome Output Patients Pattern Phase Play Positioning Attribute Postoperative Period Principal Component Analysis Procedures Property Quality of life Radial Research Resected Residual state Resolution Resources Scientist Shapes Site Societies Specialist Speech Speech Acoustics Speech Pathologist Speech Therapy Staging Stretching Structure Surface Surgeon Surgical Flaps Surgical sutures Techniques Testing Time Tissues Tongue Tumor stage United States Withdrawal Work base cancer surgery cell motility constriction disorder control healing image processing imaging modality improved kinematics malignant mouth neoplasm malignant tongue neoplasm mouth squamous cell carcinoma novel programs reconstruction response social sound speech accuracy success tongue root tool tumor wound young man young woman

项目摘要

DESCRIPTION (provided by applicant): Oral, head and neck cancer represents 3% of all cancers in the United States and is the 6th most common cancer worldwide. Recent studies have shown a five-fold increase in the incidence of squamous cell carcinomas of the oral portion of the tongue among young men and a six-fold increase among young women. Glossectomy is the surgical removal of a cancerous tumor. The amount of tongue tissue removed is not negotiable, because the surgeon must remove the entire tumor plus about 1 cm of tissue around it. The reconstructive phase focuses on maximizing the patient's post-operative quality of life, including the critical function of speech. Patients with poor speech avoid social situations, develop self-consciousness, and even depression. Surgeons must choose a reconstruction method, such as primary closure (suture the wound), or replacement with a 'flap' of tissue taken from elsewhere in the body. Larger tumors (above 4 cm in largest dimension) almost always require some type of flap. Among early stage tumors, however, there is no consensus as to the optimal closure procedure. We propose an objective study of patients for whom precise tumor-node-metastasis staging and specific surgical treatments have been established. We will study partial- to hemiglossectomy with primary closure, secondary healing and radial forearm free flap. We will focus on discovering the relationships between reconstruction technique and successful glossectomy speech as mediated by characteristics of tongue motion, kinematic properties of the residual muscles, and configurations of the vocal tract. We have research aims organized to address the following hypotheses. 1(a): Glossectomy speech quality will correlate with tongue motion pattern. 1(b): Tongue motion components that affect speech will vary by surgical type. 2(a): Glossectomy speech quality reflects the success of altered muscle mechanics. 2(b): Muscle mechanics that relate to speech quality will vary by surgical type. 3: A vocal tract model that maps geometry to acoustics can provide targeted speech therapy and can inform surgical decisions. In Aim 3 we will use the knowledge gained in Aims 1 and 2 along with both a 1D and a 3D acoustic model to represent post-glossectomy vocal tracts and then modify them to reflect changes in size and shape of flap or resected region. Results of the project will include a unique atlas of normal tongue deformation and patient comparisons, a better understanding of the impacts of tongue cancer surgery on the tongue and speech, and a tool to help understand speech outcomes of surgical modifications.

描述（由申请人提供）：口腔、头颈癌占美国所有癌症的 3%，是全球第六大常见癌症。最近的研究表明，年轻男性舌头口腔部分鳞状细胞癌的发病率增加了五倍，年轻女性增加了六倍。舌切除术是通过手术切除癌性肿瘤。切除的舌组织数量是不容协商的，因为外科医生必须切除整个肿瘤及其周围约 1 厘米的组织。重建阶段的重点是最大限度地提高患者的术后生活质量，包括关键的言语功能。言语不佳的患者会回避社交场合，产生自我意识，甚至抑郁。外科医生必须选择重建方法，例如初次闭合（缝合伤口），或用从身体其他部位取出的组织“皮瓣”进行替换。较大的肿瘤（最大尺寸超过 4 厘米）几乎总是需要某种类型的皮瓣。然而，在早期肿瘤中，对于最佳闭合程序尚未达成共识。我们建议对已建立精确肿瘤淋巴结转移分期和特定手术治疗的患者进行客观研究。我们将研究部分半舌切除术，一期闭合、二期愈合和放射状前臂游离皮瓣。我们将重点发现重建技术和成功的舌切除术言语之间的关系，这种关系是由舌头运动特征、残余肌肉的运动学特性和声道结构介导的。我们的研究目标是为了解决以下假设。 1(a)：舌切除术的语音质量与舌头运动模式相关。 1(b)：影响言语的舌头运动成分会因手术类型而异。 2(a)：舌切除术的语音质量反映了改变肌肉力学的成功。 2(b)：与语音质量相关的肌肉力学会因手术类型而异。图 3：将几何形状映射到声学的声道模型可以提供有针对性的言语治疗，并可以为手术决策提供信息。在目标 3 中，我们将使用目标 1 和 2 中获得的知识以及 1D 和 3D 声学模型来表示舌切除术后声道，然后对其进行修改以反映皮瓣或切除区域的大小和形状的变化。该项目的成果将包括正常舌头变形和患者比较的独特图集，更好地了解舌癌手术对舌头和言语的影响，以及帮助了解手术修改的言语结果的工具。

项目成果

期刊论文数量（26）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Multimodal registration via mutual information incorporating geometric and spatial context.

DOI：
10.1109/tip.2014.2387019
发表时间：
2015-02
期刊：
IEEE transactions on image processing : a publication of the IEEE Signal Processing Society
影响因子：
0
作者：
Woo J;Stone M;Prince JL
通讯作者：
Prince JL

SEMI-AUTOMATIC SEGMENTATION OF THE TONGUE FOR 3D MOTION ANALYSIS WITH DYNAMIC MRI.

利用动态 MRI 对舌头进行 3D 运动分析的半自动分割。

DOI：
10.1109/isbi.2013.6556811
发表时间：
2013
期刊：
Proceedings. IEEE International Symposium on Biomedical Imaging
影响因子：
0
作者：
Lee,Junghoon;Woo,Jonghye;Xing,Fangxu;Murano,EmiZ;Stone,Maureen;Prince,JerryL
通讯作者：
Prince,JerryL

Subject-Specific Biomechanical Modelling of the Oropharynx: Towards Speech Production.