Quality of life in male tracheoesophageal (TE) speakers.
For this study, we determined the quality of life (QOL) in individuals who had undergone total laryngectomy (TL) and who used tracheoesophageal (TE) speech as their primary method of postlaryngectomy communication. We also descriptively compared present QOL outcomes with those found in an extension of the Department of Veterans Affairs' (VA) Laryngeal Cancer Study. Thirty laryngectomized men with TE speech as their primary mode of communication were recruited for participation in the investigation. Participants completed a general information form as well as the University of Michigan Head and Neck Quality of Life (HNQOL) instrument. Results revealed a high level of self-perceived QOL in the domains of communication, eating, pain, and emotion that was empirically better than results found in a previous study involving individuals who had undergone TL and who were treated in VA hospitals. Possible reasons for the improved self-reported QOL among individuals in the present group include use of TE speech for postlaryngectomy communication, a higher level of education, and membership in a support group. The results suggest to us that these factors should be considered in postlaryngectomy care in the veteran population to optimize rehabilitation outcomes. (+info)
Intensity and fundamental frequency control in tracheoesophageal voice.
Tracheo-oesophageal voice prostheses are currently widely used following total laryngectomy. Data on maximum phonation time and spectrum have been studied by various Authors and are well known. On the contrary, intensity and fundamental frequency control have received little attention. Intensity and fundamental frequency play an important role in the prosodic aspects of speech. Fundamental frequency variations have been studied in tone language speakers, but the ability to voluntarily change intensity and fundamental frequency remain to be fully investigated. Aim of the present study was to analyse the ability of tracheo-oesophageal voice users to change intensity and fundamental frequency. A total of 12 male subjects who underwent total laryngectomy, in whom a tracheo-oesophageal prosthesis had been inserted, were considered. Maximum phonation time was calculated. Each subject was asked to utter an /a/ as loud as possible and an /a/ as soft as possible. Each subject was then asked to utter an /a/ at comfortable pitch and then at an interval of a fifth. Intensity as well as fundamental frequency variations were compared using Wilcoxon signed rank test. Correlation between maximum phonation time and variation in intensity and in fundamental frequency as well as between the two latter variables was calculated using Spearman's rank correlation coefficient. Mean maximum phonation time was 8 (+/- 3.8) sec. Mean energy was 50 (+/- 4.8) dB SPL for soft phonation and 68 (+/- 4.7) dB SPL for loud phonation. The difference observed was statistically significant (p < 0.02). Mean fundamental frequency values were 106 (+/- 14) Hz and 135 (+/- 34) Hz at the interval of a fifth. The difference observed was statistically significant (p < 0.02). Tracheo-oesophageal voice users were able to change intensity and fundamental frequency, but their control was rather poor. Variations in intensity, as well as fundamental frequency, did not show any correlation with maximum phonation time, and were not correlated with each other. In conclusion, the tracheo-oesophageal voice allows small fundamental frequency variations, but their control appears difficult. On the contrary, intensity variations appear larger and control somewhat easier. (+info)
Acoustic analysis of aperiodic voice: perturbation and nonlinear dynamic properties in esophageal phonation.
OBJECTIVES: The goal of this study was to determine whether speech breathing changes over time in laryngectomy patients who use an electrolarynx, to explore the potential of using respiratory signals to control an artificial voice source. METHODS: Respiratory patterns during serial speech tasks (counting, days of the week) with an electrolarynx were prospectively studied by inductance plethysmography in 6 individuals across their first 1 to 2 years after total laryngectomy, as well as in an additional 8 individuals who had had a laryngectomy at least 1 year earlier. RESULTS: In contrast to normal speech that is only produced during exhalation, all individuals were found to engage in inhalation during speech production, and those studied longitudinally displayed increased occurrences of inhalation during speech production with time after laryngectomy. These trends appear to be stronger for individuals who used an electrolarynx as their primary means of oral communication rather than tracheoesophageal speech, possibly because of continued dependence on respiratory support for the production of tracheoesophageal speech. CONCLUSIONS: Our results indicate that there are post-laryngectomy changes in the speech breathing behaviors of electrolarynx users. This has implications for designing improved electrolarynx communication systems, which could use signals derived from respiratory function as one of many potential physiologically based sources for more natural control of electrolarynx speech. (+info)
Tracheostoma humidifier: influence on secretion and voice of patients with total laryngectomy.