Telemedicine-enabled biofeedback electropalatography rehabilitation (TEBER): A pilot study for patients treated with surgery for oral cavity carcinoma

Douglas B Chepeha; Carly E A Barbon; Alex O Esemezie; Majd Al Mardini; Justine Philteos; Matthew E Spector; Tim Bressmann; Rosemary Martino; Scott V Bratman; John B C Cho; Andrew J Hope; Ali Abdalati Hosni; John J H Kim; Jolie G Ringash; John N Waldron; Dale H Brown; John R de Almeida; Ralph W Gilbert; David P Goldstein; Patrick J Gullane; Jonathan C Irish; Eric A Monteiro; Christopher M K L Yao

doi:10.1002/hed.27721

Telemedicine-enabled biofeedback electropalatography rehabilitation (TEBER): A pilot study for patients treated with surgery for oral cavity carcinoma

Head Neck. 2024 Apr 1. doi: 10.1002/hed.27721. Online ahead of print.

Authors

Douglas B Chepeha^{1

2}, Carly E A Barbon³, Alex O Esemezie¹, Majd Al Mardini⁴, Justine Philteos¹, Matthew E Spector⁵, Tim Bressmann⁶, Rosemary Martino⁶, Scott V Bratman⁷, John B C Cho⁷, Andrew J Hope⁷, Ali Abdalati Hosni⁷, John J H Kim⁷, Jolie G Ringash⁷, John N Waldron⁷, Dale H Brown¹, John R de Almeida¹, Ralph W Gilbert¹, David P Goldstein¹, Patrick J Gullane¹, Jonathan C Irish¹, Eric A Monteiro⁸, Christopher M K L Yao¹

Affiliations

¹ Department of Otolaryngology-Head & Neck surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
² Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA.
³ Department of Head & Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
⁴ Department of Dentistry, Maxillofacial and Ocular Prosthetics, University Health Network-Princess Margaret Cancer Center, Toronto, Ontario, Canada.
⁵ Department of Otolaryngogy-Head & Neck Surgery, University of Pittsburgh, Pittsburgh, Pensylvania, USA.
⁶ Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada.
⁷ Department of Radiation Oncology, University Health Network-Princess Margaret Cancer Center, Toronto, Ontario, Canada.
⁸ Department of Otolaryngology-Head & Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

PMID: 38561946
DOI: 10.1002/hed.27721

Abstract

Background: To address the rehabilitative barriers to frequency and precision of care, we conducted a pilot study of a biofeedback electropalatography (EPG) device paired with telemedicine for patients who underwent primary surgery +/- adjuvant radiation for oral cavity carcinoma. We hypothesized that lingual optimization followed by telemedicine-enabled biofeedback electropalatography rehabilitation (TEBER) would further improve speech and swallowing outcomes after "standard-of-care" SOC rehabilitation.

Method: Pilot prospective 8-week (TEBER) program following 8 weeks of (SOC) rehabilitation.

Results: Twenty-seven patients were included and 11 completed the protocol. When examining the benefit of TEBER independent of standard of care, "range-of-liquids" improved by +0.36 [95% CI, 0.02-0.70, p = 0.05] and "range-of-solids" improved by +0.73 [95% CI, 0.12-1.34, p = 0.03]. There was a positive trend toward better oral cavity obliteration; residual volume decreased by -1.2 [95% CI, -2.45 to 0.053, p = 0.06], and "nutritional-mode" increased by +0.55 [95% CI, -0.15 to 1.24, p = 0.08].

Conclusion: This pilot suggests that TEBER bolsters oral rehabilitation after 8 weeks of SOC lingual range of motion.

Keywords: articulation disorders; biofeedback‐electropalatography; glossectomy; oral cancer; telemedicine.

Abstract

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