Rehabilitation After Total Laryngectomy
John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford in 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).
Otorhinolaryngology (ENT)
Gozie Offiah, Arnold Hill in RCSI Handbook of Clinical Surgery for Finals, 2019
Speech rehabilitation➣ Electrolarynx➣ Blom singer valve with tracheo-oesophageal puncture
Data and Picture Interpretation Stations: Cases 1–45
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar in ENT OSCEs, 2023
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.
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.
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).
Development of a Manually Operated Communication System (MOCS) for patients in intensive care units
Published in Augmentative and Alternative Communication, 2021
Miriam A. Goldberg, Leigh R. Hochberg, Dawn Carpenter, J. Matthias Walz
A recent review (Ju, Yang, & Liu, 2020) indicates that patients regard high-tech AAC solutions in general as “useful, reliable, and acceptable.” Investigations of unmet need in this space were therefore initiated. In the ICU, high-tech approaches may include options such as a manually navigated tablet, a tablet navigated via eye-gaze (head pointing has not been studied in the ICU), or a tablet navigated via switch (which itself may or may not be manually operated). An additional category of communication tools for ICU use – those that allow for direct phonation, including an electrolarynx or a Passy-Muir valve2 with deflated tracheostomy cuff – may enable a version of oral communication that could be more familiar to the communication partner. These tools require significant training, however, and as such are potential options for only a small category of patients (Hess, 2005). They have shown levels of varying levels of benefit, often in direct comparison only with low-tech communication methods (ten Hoorn, Elbers, Girbes, & Tuinman, 2016). In comparison, this project aimed to be broadly useful with minimal required training to optimize for maximal benefit per unit of patient use time.
Related Knowledge Centers
- Mandible
- Speech Synthesis
- Phonation
- Larynx
- Laryngeal Cancer
- Esophageal Speech
- Laryngectomy
- Tracheo-Oesophageal Puncture
- Silent Speech Interface