The assessment of articulatory function encompasses auditory evaluation, instrumental assessment, and subjective evaluation of the patient. Auditory evaluation encompasses the speech intelligibility test and the 100-syllable Japanese speech intelligibility test. The speech intelligibility test entails rating speech intelligibility on a 5- or 9-point scale. The 100-syllable Japanese speech intelligibility test entails the quantification of correctly heard syllables from a set of 100, expressed as a percentage. Instrumental assessments of articulation encompass palatography, acoustic analysis, and the nasometer. Palatography facilitates the evaluation of both the presence and distribution of tongue and palate contact. Acoustic analysis is a method for appraising articulatory function through the examination of speech sounds using specialized software. The nasometer is an apparatus for assessing hypernasality.
The Speech Handicap Index （SHI） is a self-reported questionnaire aimed at gauging speech-related quality of life. The SHI comprises 30 quality-of-life questions pertaining to speech, self-assessed by the patient on a 5-point scale （0-4）. Presently, the SHI has been translated into numerous languages, including Korean and French. Nonetheless, there is no speech-specific questionnaire tailored to Japanese-speaking patients. These three methodologies have the potential to serve as indicators of treatment and training efficacy within the realm of maxillofacial prosthetic interventions.

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It has been reported that oral and feeding/swallowing functions are impaired in oral cancer patients due to postoperative organic damage. However, in clinical practice, qualitative evaluation such as “the patient is able to ingest food without aspiration” is often used as an indicator of functional recovery after surgery, so it is often unclear how much function has decreased postoperatively and whether function has recovered with maxillofacial prosthetic treatment. Therefore, our hospital has developed a flowchart for the precise examination of pre- and postoperative oral and feeding/swallowing functions in order to: （1） precisely examine whether or not oral and feeding/swallowing functions deteriorate before surgery, （2） set a target value for functional recovery after surgery, and （3） quantitatively evaluate the effectiveness of maxillofacial prosthetic treatment.
Before the flowchart was used, the presence/absence of examinations and training goals were determined based on clinical senses, but with the use of the flowchart, measurement of oral function, feeding and swallowing function, and nutritional evaluation became possible in all patients with oral cancer, and target values for functional recovery were clarified. We believe that further improvement is needed to quantify clinical sensation in the future.

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A 71-year-old female underwent marginal mandibulectomy in the left premolar and molar area, and flap reconstruction due to squamous cell carcinoma. She had used a pair of removable partial dentures （RPDs） before the surgical intervention and the RPDs were repaired in two days after visiting our department. Treatment for remaining teeth was started four months after discharge from the hospital, and the flap became stable after the treatment. A pair of RPDs was fabricated by pressure impression. At one year after delivery of the RPDs, she showed high scores of masticatory function and maximum occlusal force. The oral functions and esthetics were improved and maintained during a 4-year observation period.
This case demonstrates that treatment for remaining teeth, stability of flap and appropriate impression contributed to the stability of a prosthesis for defective jaw.

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