China
Africa
Explore chapters and articles related to this topic
Measures of Treatment Outcomes
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Helen Cocks, Raghav C. Dwivedi, Aoife M.I. Waters
Perceptual evaluation of alaryngeal speech Although attempts have been made to develop a scale for perceptual evaluation of alaryngeal speech, a reliable, reproducible perceptual rating system does not seem to exist for the laryngectomee. Van As et al54 report the use of a semantic bipolar seven-point scale (e.g. ugly–-beautiful, deviant–-normal, low–high), for both untrained and trained raters. Eadie and Doyle report the use of direct magnitude estimation (continuous) and equally appearing interval scales for the auditory perceptual rating of naturalness, severity, acceptability and pleasantness of tracheoesophageal voice.55–57 Hurren and Miller report no current evidence to support the use of acoustic instrumental measures in terms of validity. They show preliminary data support for the validity of a new tracheoesophageal voice auditory--perceptual tool the SToPS, for professional and native raters.58
Effect of total laryngectomy on vowel production: An acoustic study of vowels produced by alaryngeal speakers of Cantonese
Published in International Journal of Speech-Language Pathology, 2021
When other treatment options fail, total laryngectomy is often carried out for late stage laryngeal cancer. However, with the entire phonatory apparatus removed during the procedure, laryngeal cancer patients lose their ability to speak (Keith & Darley, 1994). Therefore, learning to speak again becomes an important part of post-laryngectomy rehabilitation. To date, four types of post-laryngectomy alaryngeal speech are available: oesophageal (ES), tracheoesophageal (TE), electrolaryngeal (EL) speech, and use of pneumatic artificial larynx (PA) (Law, 2005; Ng, Kwok, & Chow, 1997; Ng & Xiong, 2015). ES and TE speech make use of the pharyngoesophageal (PE) segment that is comprised of partly the upper oesophagus, cricopharyngeus, and inferior pharyngeal constrictor muscle as the new sound source, known as the neoglottis (Keith & Darley, 1994; Ng, Tong, & Yu, 2019; Ng & Xiong, 2015; Salmon, 1999). For both EL and PA speech, sound is generated by using an external device; an electrolarynx is placed on the anterolateral neck for speech production by EL speakers (Keith & Darley, 1994; Salmon, 1999), and PA speakers rely on the pneumatic artificial larynx with an oral tube placed inside the mouth (Ng et al., 1997). Although not common among laryngectomees in the USA, PA speech is commonly adopted as an alaryngeal speech in Asia including Hong Kong, Japan, and Taiwan. The primary sound source of a pneumatic artificial larynx lies in the elastic rubber reed located inside the PA device. Upon phonation, air flowing through the PA device will set the rubber reed into vibration, thus generating periodic sound (Ng et al., 1997).
Listener impressions of alaryngeal communication modalities
Published in International Journal of Speech-Language Pathology, 2021
Stephanie M. Knollhoff, Stephanie A. Borrie, Tyson S. Barrett, Jeff P. Searl
Regardless of speaker sex, all alaryngeal modes within the current study strongly affected impressions of employability relative to impressions of likeability and intelligence. The current authors’ believe this is important because existing literature suggests that both occupational and social attributes play a significant role in an individual’s quality of life. Indeed for adults, occupation has been identified as the attribute that correlates most highly to overall quality of life (Flanagan, 1982). Only 15% of individuals who receive a total laryngectomy return to work post-surgery (Ramirez et al., 2003). Low levels of employment may be contributing to reduced quality of life reported by individuals following a total laryngectomy (Costa et al., 2018; Osazuwa-Peters et al., 2018; Palmer & Graham, 2004; Ramirez et al., 2003). Results from the current study, in which the same stimuli received relatively favourable ratings for likability and intelligence but not employability, suggests that employability may be judged with more rigour than other attributes. Confirming this result through additional studies that include more alaryngeal stimuli will be necessary. The current authors’ speculate that employability may be judged more harshly because the outcomes (i.e. hiring a person) could affect the listener’s own quality of life as they could either gain or lose income based on employment decisions they make. Further investigation is needed to identify if there are specific speech characteristics, characteristic combinations, or indeed other factors that trigger relatively poorer impressions of employability for those using alaryngeal speech. A multifaceted consideration of acoustic and perceptual features is likely needed to enhance understanding of listener impressions.
The Lombard effect associated with Chinese male alaryngeal speech
Published in International Journal of Speech-Language Pathology, 2019
Manwa L. Ng, Gloria C. K. Tsang
Seeing the negative effect on speech intelligibility and acceptability associated with the diminished intensity in alaryngeal speech after total laryngectomy, researchers and practitioners have been seeking ways to improve alaryngeal voices by increasing the vocal loudness. In fact, training to increase vocal loudness has been an important part of post-laryngectomy speech rehabilitation. Among the various ways to enhancing vocal loudness, the Lombard effect might be a feasible alternative.