Speech rehabilitation after total laryngectomy with voice prostheses: phonatory results

Abstract

The approaches for voice rehabilitation after laryngectomy vary significantly, as they can be classified into natural and device-aided (external and surgical). The techniques differ in degree of accessibility, success and vocal results. Until the introduction of surgical methods, esophageal speech was the mainstay of rehabilitation. It is associated with long training period with questionable success. The electrolarynx, which in our country is still traditionally accepted as the main method of voice rehabilitation after laryngectomy, generates speech with a low degree of intelligibility and mechanical sound. The implantation of a voice prosthesis in a surgically shaped tracheoesophageal fistula is currently accepted as the gold standard. The aim of the study was phoniatric analysis of voice production in alaryngeal speech after tracheo-oesophageal puncture and implantation of a voice prosthesis. The characteristics of tracheoesophageal and oesophageal speech are compared. The obtained results show that the voice production after implantation of a voice prosthesis significantly exceeds the oesophageal voice in terms of average duration of phonation with one air bolus, number of words uttered with one bolus, and the pace and expressiveness of speech.