Development and validation of a webcam-based tool to assess tongue motility and its correlation with speech intelligibility and swallowing following tongue cancer surgery.

Abstract

e18088 Background: Tongue carcinoma ranks among the most prevalent malignancies in the Nepalese population. The tumour and its treatment adversely affect tongue function, particularly tongue motility. Despite being a crucial predictor of post-treatment tongue function, a standardised non-invasive assessment method is lacking. Objective: To evaluate an indigenous webcam-based software for measuring tongue motility and its correlation with speech intelligibility and swallowing functions. Methods: A webcam-based software was developed and validated for assessing tongue motility, measuring upward, protrusion, and right, and left lateral deviation distances. A speech-language pathologist evaluated speech intelligibility, while swallowing function was assessed using the MD Anderson Dysphagia (MDADI) questionnaire. Results: The software demonstrated high reliability between observers (Cronbach’s α > 0.9 and P-value < 0.001). Seventy-five patients were recruited, with primary closure being the most common mode of reconstruction (38 patients, 50.6%), followed by radial artery forearm free flap (31 patients, 41.3%) and strap muscle flap (6 patients, 8.0%). Upward tongue movement showed significant correlations with both speech (p-value 0.002) and swallowing functions (p-value 0.009). Speech intelligibility was significantly poorer in the strap muscle group compared to the primary closure group (p-value 0.001) and the RAFFF group (p-value 0.004). Swallowing function was significantly poorer in the strap muscle flap group compared to the primary closure group (p-value 0.003) and the RAFFF group (p-value 0.009) as measured by the total MDADI score. Radiotherapy significantly worsened post-operative swallowing function (p-value 0.001). Conclusions: The webcam-based tongue motility tool provides an easy-to-use, reliable, and cost-effective method for recording different tongue movements. Primary closure and RAFFF were significantly superior to strap muscle flap in terms of postoperative functional outcomes. Upward tongue movement significantly correlated with both post-operative speech and swallowing functions.