Speech Breathing Patterns During Tracheoesophageal Speech

Abstract

Although tracheoesophageal speech (TES) uses pulmonary air to drive voice production, it was hypothesized that the speech breathing patterns of patients using TES would differ from normal speakers, as speakers compensated for the increased resistance associated with alaryngeal phonation and the effects of air loss from occasional incomplete stomal occlusion. Instrumental measurements of respiratory kinematics were used to study lung volume initiation, termination, and excursion in speech and nonspeech respiratory tasks for nine participants who used TES and nine matched controls. On the nonspeech tasks, the kinematic patterns of the TES group displayed no difference from the normal participants. On speech tasks, however, they demonstrated significantly (p <0.05) reduced lung volume excursions (LVE) in maximum sustained phonation and significantly increased LVEs in both reading and conversation. The results suggest that the TES group had less efficient use of their expiratory breath stream for maximum sustained phonation as signified by reduced LVEs. In the absence of reduced respiratory function in nonspeech tasks, this finding appears to relate to either increased phonatory resistance and/or possible stomal air loss associated with producing phonation. The results of the increased LVEs on the connected speech tasks demonstrate that patients employed active compensatory patterns of speech breathing to optimize utterance length.