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Data and Picture Interpretation Stations: Cases 1–45
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
An electrolarynx is a handheld battery-operated device pressed against the skin of the upper neck that produces monotone buzz that the user articulates into speech. This is easy to use but creates a very ‘robotic’ voice quality that many patients dislike.
Otorhinolaryngology (ENT)
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
Speech rehabilitation➣ Electrolarynx➣ Blom singer valve with tracheo-oesophageal puncture
Rehabilitation After Total Laryngectomy
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Oesophageal speech requires air to be taken into the top of the oesophagus either by injection or inhalation,14 and then forced out again causing the newly reconstructed pharynx, the PE or vibratory segment, to vibrate in response to the flow of air and produce sound. As in normal laryngeal voice production, this sound is amplified by the resonating cavities above and modified into speech by the articulators, tongue, teeth, lips and soft palate. The electrolarynx produces a sound that is then transmitted into the resonating cavities either by direct pressure of the machine against the skin of the upper neck or through a tube directly into the oral cavity. SVR has largely replaced these other methods, being easier to learn and producing better quality voice (Table 15.2).
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
There are three primary options after a total laryngectomy that allow for alaryngeal, verbal communication in the USA: electrolarynx (EL), oesophageal speech (ES) and tracheoesophageal speech (TES). An EL involves an artificial vibratory mechanism that is located within an external device. This vibratory mechanism, coupled with the shaping of sounds via the lips, teeth and tongue is how speech is produced. Commonly utilised as a handheld device that is placed against the neck region, but also with intraoral options, an EL is known for its monotone, computer-like voice quality (Clark & Stemple, 1982). Development of EL devices now allows for some alterations of pitch and volume as well as more handsfree options (Kaye, Tang, & Sinclair, 2017). EL communication requires a device external to the body and ongoing maintenance (i.e. batteries, cleaning).
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
For EL speech, an electrolarynx which is a handheld device is used as a new sound source. Sound generated by the electrolarynx is propagated transcervically into the vocal tract for resonance. Poor coupling between the device and the neck tissue often results in coupling noise e.g. EL noise radiating from the gap between the neck tissue and the device, deteriorating EL voice quality. Although EL’s intensity level mostly depends on the settings of the electrolarynx, studies have revealed that EL speech is associated with a lower vocal intensity than laryngeal speakers (e.g. Liu & Ng, 2009; Ng, Gilbert, & Lerman, 1998, 2001). In addition to altering the power of the electrolarynx, it has been reported that some competent EL speech can manipulate their vocal intensity by varying the force with which they couple the EL device on their neck during speech production for some electrolarynges (Zeine & Brandt, 1988) or changing articulatory postures to improve resonance.
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).