Lymphangiomatous lesions are rare congenital malformations of the lymphatic system that occur throughout the body with greater frequency in the cervico facial area. The incidence of lymphangiomas has been reported to range from 1.2 to 2.8 per 1000 newborns. The most prominent sign or symptom of all lymphangiomas is the presence of mass. It had associated symptoms like upper respiratory obstructions, feeding problems and dysphagia.
Surgical removal of the neoplasm still appears to be the best choice in the treatment of lymphangiomas. The common sites of lymphagioma include head, neck and oral cavity. The lymphangiomas in the neck region can compress the cranial nerves pertaining to the site of lesion and also can results in cranial nerve injury after surgical removal. This in turn can results in disturbed speech.
The aim of the study is to profile the speech characteristics of a client with lymphangioma after the surgical excision.
The client was a 32 year old female who presented to the outpatient clinic with the chief complaint of slurring of speech after the surgical removal of lymphangioma and diagnosed as cranial nerve injury during the surgery of lymphangioma. The detailed evaluation of Oral Peripheral Mechanism Examination, Speech subsystems, Swallowing skills and cranial nerve examination related to speech and hearing was done.
Results and Discussion
The speech evaluation shows slow speech. Significant findings from oral peripheral mechanism examination were lips slightly deviated towards left with functions intact and inadequate lateralization of jaw movements. Tongue with reduced strength and function was noticed. Swallowing assessment shows slow bolus preparation for solids. Cranial nerve examination reveals injury in trigeminal, hypoglossal and facial nerve during surgery. Client had reduced MPD of 9 seconds.
It can be concluded that lymphangioma has an effect on speech before and after surgery. The compression of nerves can be the reason for impaired speech before surgery and cranial nerves injury during surgery can be attributed as the cause of speech disturbances post surgery. Hence detailed speech evaluation should be carried out in these clients and can be consider for therapeutic intervention for better prognosis.
Audience Take Away:
The current study helps the practicing clinicians in:
- Identifying a rare condition like lymphagioma
- Knowing the effect of lymphagioma in speech production
- Aids in speech assessment and management of clients with lymphagioma