Speech and Voice after Laryngectomy: Perceptual and Acoustical Analyses of Tracheoesophageal Speech Related to Voice Handicap Index

Abstract

Objective: To perform perceptual and acoustical analyses of tracheoesophageal (TE) speech and relate these analyses to self-reported voice handicap. Methods: Recordings of 35 TE speakers were perceptually assessed by 5 speech-language pathologists. Acoustical analyses were made of voice aspects and temporal speech aspects. Self-assessments of voice were made with the Voice Handicap Index (VHI). Results: Perceptual assessment of TE speech showed significant correlations between overall degree of deviation and low speaking rate, deviant articulation, monotonous intonation, roughness and low pitch. The overall degree of deviation correlated significantly with acoustical measurements of speaking rate, articulation rate, and phrase length. Significant correlations were also found between assessed pitch and measured fundamental frequency, between assessed speaking rate and measured number of words per minute, and between assessed phrase length and measured number of syllables per breath. Self-assessments of VHI were significantly correlated with voice intensity and temporal speech aspects such as total reading time, phrase length, and percent pause time. No significant correlations were found between perceptual assessment and VHI degree. Conclusion: The listeners’ ratings of overall degree of deviation in TE speech showed relations to both voice quality and temporal aspects in speech. The TE speakers’ voice handicap degree were mainly related to changes in temporal aspects of speech.