Correlation between tracheoesophageal voice and speech and intraluminal pharyngoesophageal transition pressure

Rehabilitation of individuals with total laryngectomy.

To correlate the voice and speech proficiency of individuals with total laryngectomy, users of tracheoesophageal, prosthesis with the intraluminal pharyngoesophageal transition pressure at rest and during phonation.

Twelve individuals with total laryngectomy and with tracheoesophageal voice, users of speech prosthesis, were submitted to a voice and speech sample gathering and registration. These individuals were assessed by three experts using a specific protocol for the evaluation of tracheoesophageal communication. Individuals also underwent esophageal manometry in order to evaluate the intraluminal pharyngoesophageal transition pressure during rest and phonation.

During phonation, individuals who had been characterized by the experts as good speakers (16.7%) presented average values of pressure amplitude during pharyngoesophageal transition of 27.48 mmHg. Average amplitude of 30.63 mmHg was observed for individuals classified as moderate speakers (52.5%), and of 38.72 mmHg for individuals classified as poor speakers (30.8%). During rest, the good speakers presented an average pressure of 14.72 mmHg, the moderate speakers of 13.04 mmHg and the poor speakers of 3.54 mmHg.

The good speakers presented the lowest amplitude values of pharyngoesophageal transition pressure during phonation. However, the pressure observed in the rest condition was higher for the good speakers and lower for the poor speakers, suggesting that the raise in the pharyngoesophageal transition pressure during phonation damages the quality of tracheoesophageal communication when using speech prosthesis.