Speech+Therapist

= Speech and Language Therapist  =

==== A speech and Language Therapist (SLT) plays an active role for the patient post-surgery predominantly (Rapidis, 1980). An SLT will deal with the patient for any swallowing difficulties the patient may have (dysphagia) and also for any speech problems resulting in the removal of the tumor (such as nerve innovation and other articulation/ phonatory issues which may arise) (Carrau, 1999). ====

The Speech Therapist may request a Video fluoroscopy and conduct a swallow evaluation if the patient is assessed to be suffering from post-operative dysphagia. This will give the SLT the ability to examine the structures involved in a swallow, and their functioning after surgery (Leonard & Kendall, 1997).

There are several factors the SLT will examine during an oral evaluation which include:

(Oral phase)
 * Reflexes and responses (bite, gag and tongue)
 * Sensation
 * Structure
 * Movement (Jaw, lips, tongue, velum)
 * Oral sensorimotor integrity
 * Secretions
 * Articulation

(Pharyngeal and Laryngeal)
 * Vocal quality/ changes
 * pitch control/ range
 * Breathing
 * Volitional cough/ throat clear
 * Saliva swallow: Laryngeal managment
 * Liquid and/ or food swallow (Video fluoroscopy)

Treatment plans by the SLT will most commonly include improving the strength, mobility, and endurance of structures associated with speech and swallowing. As the patient will still be receiving radiotherapy post- surgery, the level of strength and innervation of these structures may fluctuate (Leonard & Kendall, 1997). This is where the SLT plays an important role in supporting the patients oral functioning.

Example of a Video fluoroscopy:

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