A prospective study of tracheoesophageal speech.

Abstract

Gates et al suggested that commonly accepted statistics on esophageal speech acquisition may be inflated because they are compiled from retrospective observations that tend to exclude high-risk or poor-outcome patients who are unavailable or unwilling to be assessed. Using a multi-institution prospective study design, they demonstrated that at six months following laryngectomy only 12 (26%) of their 47 patients used esophageal speech. We prospectively assessed a group of 47 laryngectomees' pretracheoesophageal puncture and posttracheoesophageal puncture to determine the efficacy of this speech-rehabilitation method. Forty-four patients (94%) achieved good to superior tracheoesophageal speech, and, at one year, 39 patients (83%) continued to use their voice prosthesis. Results of this study reveal (1) preoperative speech intelligibility and acceptability, (2) predictive value of the preoperative esophageal insufflation test, (3) speech intelligibility and acceptability four days following initial voice prosthesis placement, (4) cost profiles, and (5) results and experiences at one year.