Abstract
BackgroundEsophageal speech (ES), tracheoesophageal speech (TES) and/or electrolarynx speech (ELS) are three speech rehabilitation methods which are commonly provided after total laryngectomy (TL).MethodsA systematic review of the literature was conducted to evaluate comparative acoustic, perceptual, and patient-reported outcomes for ES, TES, ELS and healthy speakers.ResultsTwenty-six articles could be included. In most studies, methodological quality was low. It is likely that an inclusion bias exists, many studies only included exceptional speakers. Significant better outcomes are reported for TES compared to ES for the acoustic parameters, fundamental frequency, maximum phonation time and intensity. Perceptually, TES is rated with a significant better voice quality and intelligibility than ES and ELS. None of the speech rehabilitation groups reported clearly better outcomes in patient-reported outcomes.ConclusionsStudies on speech outcomes after TL are flawed in design and represent weak levels of evidence. There is an urge for standardized measurement tools for evaluations of substitute voice speakers. TES is the favorable speech rehabilitation method according to acoustic and perceptual outcomes. All speaker groups after TL report a degree of voice handicap. Knowledge of caretakers and differences in health care and insurance systems play a role in the speech rehabilitation options that can be offered.
Highlights
IntroductionAs a consequence of total laryngectomy (TL), patients lose their natural voice, making speech rehabilitation with a substitute sound source a major rehabilitation goal
Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.As a consequence of total laryngectomy (TL), patients lose their natural voice, making speech rehabilitation with a substitute sound source a major rehabilitation goal
Secondary acoustic outcomes of interest were jitter, shimmer, intensity, spectral tilt and maximum phonation time (MPT). These outcome variables are frequently used in the literature some are known to be less reliable in substitute voicing [16, 17]
Summary
As a consequence of total laryngectomy (TL), patients lose their natural voice, making speech rehabilitation with a substitute sound source a major rehabilitation goal. The three main rehabilitation options are esophageal speech (ES), tracheoesophageal speech (TES), and electrolarynx speech (ELS) [1]. In TES, pulmonary air channeled through a voice prosthesis or tracheoesophageal (TE) fistula. Esophageal speech (ES), tracheoesophageal speech (TES) and/or electrolarynx speech (ELS) are three speech rehabilitation methods which are commonly provided after total laryngectomy (TL). Methods A systematic review of the literature was conducted to evaluate comparative acoustic, perceptual, and patient-reported outcomes for ES, TES, ELS and healthy speakers. TES is rated with a significant better voice quality and intelligibility than ES and ELS. TES is the favorable speech rehabilitation method according to acoustic and perceptual outcomes. Knowledge of caretakers and differences in health care and insurance systems play a role in the speech rehabilitation options that can be offered
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