[Comparative evaluation of the voice prosthesis after laryngectomy]

Voice quality was assessed in 44 laryngectomized patients using 13 subjective and 8 objective criteria. All patients were using either esophageal voice. Servox vibrator or a voice prosthesis. Five of eight patients with voice prostheses had secondary tracheo-esophageal punctures. Subjective assessment showed better results for most of the criteria in favor of the voice prosthesis. With objective measurements, maximum phonation times and maximum numbers of syllables per intake of air were significantly higher in patients with voice prostheses compared with other techniques for voices restoration. Overall intelligibility in the postlaryngectomy "telephone test" was obviously better in the patients using the prostheses than in those with esophageal voice or Servox vibrator voice, while no significant differences were found among prostheses and esophageal voices in the medium speed of speaking, various sound pressure levels and medium habitual pitch range. In patients with primary voice prostheses maximum phonation time was longer (average, 2.5 s) than in patients with secondary voice prostheses. Overall intelligibility of the different groups was not significantly influenced by age. The need for postoperative voice rehabilitation was significantly higher in patients with esophageal voices compared with those using Servox vibrator voice or a voice prostheses. Our results support in principle primary tracheo-esophageal puncture for a voice prostheses as best treatment of the laryngectomized patient.