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Alternative voice after laryngectomy using a sound-producing voice prosthesis
M van der Torn1, M P de Vries, J M Festen
1Department of Otolaryngology/Head & Neck Surgery, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
The Laryngoscope
|February 24, 2001
Summary
A new pneumatic voice prosthesis shows promise for improving voice quality in female laryngectomees with a hypotonic pharyngoesophageal segment. This alaryngeal voice restoration device offers better pitch and voice quality without compromising intelligibility.
Area of Science:
- Otolaryngology
- Speech-Language Pathology
- Biomedical Engineering
Background:
- Laryngectomy necessitates alaryngeal voice restoration.
- Tracheoesophageal (TE) shunts are a common method for voice rehabilitation.
- Hypotonic pharyngoesophageal (PE) segments can present challenges in voice quality for some patients.
Purpose of the Study:
- To evaluate a novel pneumatic artificial voice source integrated into a TE shunt valve.
- To improve voice quality in female laryngectomees, particularly those with a hypotonic PE segment.
Main Methods:
- An experimental, randomized, crossover trial was conducted.
- A prototype pneumatic sound source with a silicone lip was tested in vitro and in six laryngectomees.
- Evaluations included speech rate, phonation time, perceptual voice assessment, intelligibility tests, patient self-assessment, and acoustical/aerodynamic measurements.
Main Results:
- The prototype demonstrated benefits for female laryngectomees with a hypotonic PE segment.
- Voice quality and average pitch improved without affecting intelligibility or airflow.
- Limited pitch regulation was observed.
Conclusions:
- The pneumatic voice mechanism is feasible and does not impede airflow.
- Further development is needed to generate a suitable pitch for male laryngectomees.
- Achieving a wide melodic and dynamic range within physiological airflow is crucial for widespread adoption.