Perceptive, temporal, and aerodynamic evaluation of the tracheoesophageal voice

Abstract

Objectives: The aim of this study was to evaluate the perceptive characteristics of tracheoesophageal speech and its relations with temporal and aerodynamic findings. Methods: Eighteen patients who underwent total laryngectomy and tracheoesophageal prosthesis insertion for voice rehabilitation were evaluated regarding the perceptive characteristics, temporal evaluation and aerodynamics aspects of this modality of rehabilitation. The perceptive aspect evaluated was satisfaction with own voice quality. Through 5 speech therapists judgment, we studied intelligibility during text lecture, phonatory pauses in number count from 1 to 20, stomal noise, loudness, and voice pattern. Temporal evaluation was executed through maximum phonation time of the vowel /a/. The aerodynamics aspects analyzed were: phonatory flow, speech pressure level, phonatory volume, articulatory pressure, and tracheal pressure. Results: Three distinct voice groups were defined: neutral, compressed, and strain-strangled, with worse quality and constriction in this order. We found that bigger the constriction, the worse the self-satisfaction with voice quality ( P = 0.023*). Intelligibility evaluation showed significant difference between groups ( P = 0.002*), allowing distinguishing neutral voices as well adapted. The evaluation of the tracheal pressure resulted a significant difference ( P = 0.023*), which was useful to define neutral voices when compared to strain-strangled voices. Aerodynamic evaluation through phonemes /i//pi//pi/, performed with the use of a computerized system, allowed us to measure articulatory pressure accurately, and the statistical analysis resulted significant ( P = 0.014*) differing compressed voices from those strain-strangled voices. Conclusions: The perceptual evaluation differentiated 3 distinct patterns of tracheoesophageal voices production, and combined with temporal and aerodynamic findings we could be able to establish the adaptation of this modality of voice rehabilitation. *Statistical significance