5515
document
Alternative voice after laryngectomy using a sound-producing voice prosthesis . OBJECTIVE To improve the voice quality of female laryngectomees and/or laryngectomees with a hypotonic pharyngoesophageal ( PE ) segment by means of a pneumatic artificial source of voice incorporated in a regular tracheoesophageal ( TE ) shunt valve . STUDY DESIGN Experimental , randomized , crossover trial . METHODS The new sound source consists of a single silicone lip , which performs an oscillatory movement driven by expired pulmonary air flowing along the outward-striking lip through the TE shunt valve . A prototype of this pneumatic sound source is evaluated in vitro and in six laryngectomees . In vivo evaluation includes speech rate , maximal phonation time , perceptual voice evaluation of read-aloud prose by an expert listener , speech intelligibility measurements with 12 listeners , and self-assessment by the patients . Moreover , extensive acoustical and aerodynamic in vivo registrations are performed using a newly developed data acquisition system . RESULTS The current prototype seems beneficial in female laryngectomees with a hypotonic PE segment only . For them the sound-producing voice prosthesis improves voice quality and increases the average pitch of voice , without decreasing intelligibility or necessitating other pressure and airflow rates than regular TE shunt speech . Pitch regulation of this prosthetic voice is possible , yet limited . CONCLUSIONS The mechanism is feasible and does not result in unacceptable airflow resistance . For this new mechanism of alaryngeal voice to become an established technique for postlaryngectomy voice restoration , a voice suitably pitched for male laryngectomees has to be generated and a large part of the melodic and dynamic range of the sound source has to be attainable within physiological airflow rates .
5516
Intervention_Physical
laryngectomy
5517
Intervention_Other
sound-producing voice prosthesis
5518
Intervention_Physical
pneumatic artificial source of voice incorporated in a regular tracheoesophageal ( TE ) shunt valve
5519
Intervention_Other
pneumatic sound source
5520
Intervention_Other
sound-producing voice prosthesis
5521
Outcome_Physical
improve the voice quality
5522
Outcome_Physical
pneumatic artificial source of voice incorporated in a regular tracheoesophageal ( TE ) shunt valve .
5523
Outcome_Physical
speech rate , maximal phonation time , perceptual voice evaluation of read-aloud prose by an expert listener , speech intelligibility measurements with 12 listeners , and self-assessment by the patients .
5524
Outcome_Other
extensive acoustical and
5525
Outcome_Physical
aerodynamic in vivo registrations
5526
Outcome_Other
newly developed data acquisition system .
5527
Outcome_Physical
improves voice quality and increases the average pitch of voice , without decreasing intelligibility or necessitating other pressure and airflow rates than regular TE shunt speech . Pitch regulation
5528
Outcome_Other
feasible
5529
Participant_Condition
laryngectomy
5530
Participant_Sex
female
5531
Participant_Condition
laryngectomees
5532
Participant_Condition
laryngectomees with a hypotonic pharyngoesophageal ( PE ) segment
5533
Participant_Sample-size
six
5534
Participant_Condition
laryngectomees
5535
Participant_Condition
speech intelligibility measurements
5536
Participant_Sex
female
5537
Participant_Condition
laryngectomees with a hypotonic PE segment
5538
Participant_Sex
male
5539
Participant_Condition
laryngectomees