Related Experiment Video
Updated: Jun 18, 2026

A Protocol for Comprehensive Assessment of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis (ALS)
Published on: February 21, 2011
Perceptual evaluation and acoustic analysis of pneumatic artificial larynx
Jie Jie Xu1, Xi Chen, Mei Ping Lu
1Department of Otorhinolaryngology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. xujiejie2@hotmail.com
Objective:
To investigate the perceptual and acoustic characteristics of the pneumatic artificial larynx (PAL) and evaluate its speech ability and clinical value.
Study Design:
Prospective study.
Setting:
The study was conducted in the Voice Lab, Department of Otorhinolaryngology, The First Affiliated Hospital of Nanjing Medical University.
Subjects And Methods:
Forty-six laryngectomy patients using the PAL were rated for intelligibility and fluency of speech. The voice signals of sustained vowel /a/ for 40 healthy controls and 42 successful patients using the PAL were measured by a computer system. The acoustic parameters and sound spectrographs were analyzed and compared between the two groups.
Results:
Forty-two of 46 patients using the PAL (91.3%) acquired successful speech capability. The intelligibility scores of 42 successful PAL speakers ranged from 71 to 95 percent, and the intelligibility range of four unsuccessful speakers was 30 to 50 percent. The fluency was judged as good or excellent in 42 successful patients, and poor or fair in four unsuccessful patients. There was no significant difference in average fundamental frequency, maximum intensity, jitter, shimmer, and normalized noise energy (NNE) between 42 successful PAL speakers and 40 healthy controls, while the maximum phonation time (MPT) of PAL speakers was slightly lower than that of the controls. The sound spectrographs of the patients using the PAL approximated those of the healthy controls.
Conclusion:
The PAL has the advantage of a high percentage of successful vocal rehabilitation. PAL speech is fluent and intelligible. The acoustic characteristics of the PAL are similar to those of a normal voice.
Related Concept Videos
Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like asthma or COPD,...
Physical Assessment of the Respiratory Tract III: Percussion
Percussion in Respiratory Assessment
Percussion evaluates underlying tissue composition with audible and tactile vibrations,...
Physical Assessment of the Respiratory Tract IV: Auscultation
Breath Sounds
Breath sounds are categorized into vesicular, bronchovesicular, and bronchial.
Larynx
Anatomy of the Larynx
The larynx consists of various components, including cartilage, muscles, and vocal cords. Its structure includes three large unpaired cartilages—the thyroid, cricoid, and epiglottis—and three smaller paired cartilages—the arytenoids, corniculates, and...
Respiratory System Abnormal Finding II: Palpation and Auscultation
Palpation Findings
During a respiratory assessment, palpation can reveal several vital abnormalities:
Physical Assessment of the Respiratory Tract II: Palpation
Thoracic Palpation
Thoracic palpation detects tenderness, masses, lesions, respiratory excursions, and vocal fremitus. The nurse assesses...
