Nasalance and nasality of tracheoesophageal speech in total laryngectomee

Adriana Pereira Defina Iqueda,Telma Kioko Takeshita,Nathalia Dos Reis,Hilton Ricz,Lilian Aguiar-Ricz

doi:10.1590/s2317-17822013000500011

Adriana Pereira Defina Iqueda, Telma Kioko Takeshita + Show 3 more

Open Access

https://doi.org/10.1590/s2317-17822013000500011

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Abstract

The objective of this study was to determine the rates of nasalance for total laryngectomized users of a tracheoesophageal voice prosthesis and correlate them with the findings of auditory-perceptual assessment of nasality. In this study, 25 total laryngectomized users, including 20 men and five women, with a mean age of 63 years old participated. All the participants had a tracheoesophageal voice prosthesis and underwent treatment for the rehabilitation of tracheoesophageal communication. These patients were submitted to nasalance assessment using nasometry and auditory-perceptual evaluation of nasality and were rated by trained speech therapists. The nasalance values obtained for nasal (59.92%) and oral (18.64%) sentences were within the normal limits for laryngeal speakers of Brazilian Portuguese language. It was possible to observe the presence of nasality in nasal sentences and its absence in oral sentences among most speakers. Specificity was found to be 100% for nasal sentences and sensitivity was 100% for oral sentences. It was not possible to calculate these values for the oral sentences. Total laryngectomized patients with tracheoesophageal voice prostheses have adequate vocal nasality compatible with nasometry rates.

Highlights

The effective development of alaryngeal communication after total laryngectomy is still a major challenge to the field of science and enables the social, emotional and economic reorganization of laryngectomized patients.Tracheoesophageal voice, by the use of the tracheoesophageal prosthesis (TEP), is the form of alaryngeal communication that is closer to laryngeal voice[1]
Important information has been added from findings in examinations, such as esophageal manometry[6,7,8] and videofluoroscopy[3,9,10], to understand how the structures of the digestive tract and the pharyngoesophageal segment participate in the production of the tracheoesophageal sound
The mean of values found in the nasometric assessment for nasal sentences was 59.92%, and for oral sentences, it was 18.64%, which were within normality for laryngeal speakers of Brazilian Portuguese language (Table 1)

Summary

Introduction

The effective development of alaryngeal communication after total laryngectomy is still a major challenge to the field of science and enables the social, emotional and economic reorganization of laryngectomized patients.Tracheoesophageal voice, by the use of the tracheoesophageal prosthesis (TEP), is the form of alaryngeal communication that is closer to laryngeal voice[1]. The effective development of alaryngeal communication after total laryngectomy is still a major challenge to the field of science and enables the social, emotional and economic reorganization of laryngectomized patients. Out of the current possibilities of vocal rehabilitation, TEP has been the method mostly accepted by specialists and laryngectomized patients, because this method allows fast learning and an effective performance of voice quality. Important information has been added from findings in examinations, such as esophageal manometry[6,7,8] and videofluoroscopy[3,9,10], to understand how the structures of the digestive tract and the pharyngoesophageal segment participate in the production of the tracheoesophageal sound. Little is known about the participation of the rhinopharynx in the nasalance and nasality of the tracheoesophageal voice. Nasalance is a physical measurement that corresponds to the relative amount of acoustic energy released by the nasal cavity during speech, and nasality concerns “the subjective perception that a listener has in relation to the nasal speech component”(11)

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