[The voice and speech quality in laryngectomy patients rehabilitated with second generation voice prosthesis]

Voice rehabilitation with the application of voice prostheses is a method of choice in surgical rehabilitation of patients following total laryngectomy.

To compare voice quality and fistula speech with use of second generation voice prostheses to voice and esophageal speech in patients rehabilitated with vocal method.

The following study comprised 37 patients with fistula speech (group I). The assessment of voice quality included subjective and objective examination and acoustic analysis of fistula speech and aesophageal. Examination results were compared with data obtained in 15 patients with oesophageal voice of similar age and gender composition (group II). The acoustic analysis was performed using IRIS Medicom software. Fo values and Jitter, Shimmer, HNR parameters were analysed.

All examined patients with fistula speech demonstrated a permanent capacity of speaking, which enabled efficient verbal communication. Average values obtained during 'perception test' located this type of phonation between good and very good speech. Formant recordings in narrow-band spectrographs indicated relatively normal supraglottal articulation which is a factor conditioning good speech comprehension. During subjective assessment, fistula voice and speech were moderately loud, dull, hoarse, uttered in unrestrained, breathed way rather than being forced. Persistence of the pathologic phonation was confirmed by acoustic voice evaluation parameters (Jitter, Shimmer, HNR and Fo).

Examination findings confirm better voice quality obtained in rehabilitation with second generation voice prostheses as compared to oesophageal voice and speech resulting from natural rehabilitation process.