Abstract
Objective Objective. Both female laryngectomees in particular, and laryngectomees with a hypotonic pharyngo-oesophageal (PE) segment, tend to have severe problems with their weak and low-pitched tracheo-oesophageal (TE) shunt voice. The objective of the current study is the development and tin-vivo evaluation of a sound producing voice prosthesis to improve the voice of these patients. Patients and methods. Prototypes for an alternative sound source consist of a tube containing a vibrating silicone lip which is inserted into an existing voice prosthesis. So far the sound producing voice prosthesis has been tested in seven laryngectomees using objective and perceptual voice quality tests as well as aerodynamic and acoustic parameters. Results. Four voices improved from extremely weak to an average TE shunt voice with an acceptable dynamic range, requiring normal intratracheal pressures. Three TE shunt voices did not improve with the first prototypes: the high-pitched sound of the alternative sound source could not overcome the low-pitched ‘noise’ produced by the patients' PE segment. Conclusions. Alaryngeal voice production by means of a sound producing prosthesis is feasible and does not result in unacceptable airflow resistance. Pitch regulation of this prosthetic voice is possible. A functional PE segment influences the attained voice with the new prosthesis.
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