Correlation of Maximum Phonation Time and Vocal Intensity With Intraluminal Esophageal and Pharyngoesophageal Pressure in Total Laryngectomees

Takeshita-Monaretti, Telma Kioko; Dantas, Roberto Oliveira; Ricz, Hilton Marcos Alves; Aguiar-Ricz, Lilian Neto

doi:10.1177/0003489414538766

Cited by 7 publications

(11 citation statements)

References 27 publications

(54 reference statements)

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“…Even with this state-of-the-art voice rehabilitation, patients with laryngectomy experience limited phonatory capacity, with a lower and variable fundamental frequency, less aerodynamic control and decreased dynamic range. 9,10 Laryngectomees who are less satisfied with their vocal quality report making fewer phone calls, being more anxious about speaking with others and having fewer friends. 11 Voice intensity and intelligibility over background noise are two variables in TEP speech that correlate with greater quality of life, but those are not achievable by all patients.…”

Section: Introductionmentioning

confidence: 99%

Pilot study for a novel and personalized voice restoration device for patients with laryngectomy

Rameau¹

2019

Head & Neck

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Background: The main modalities for voice restoration after laryngectomy are the electrolarynx, and the tracheoesophageal puncture [Correction added on 30 January 2020 after first online publication: The preceding sentence has been revised. It originally read "The main modalities for voice restoration after laryngectomy are the electrolarynx and the tracheoesophageal puncture."]. All have limitations and new technologies may offer innovative alternatives via silent speech. Objective: To describe a novel and personalized method of voice restoration using machine learning applied to electromyographic signal from articulatory muscles for the recognition of silent speech in a patient with total laryngectomy.Methods: Surface electromyographic (sEMG) signals of articulatory muscles were recorded from the face and neck of a patient with total laryngectomy who was articulating words silently. These sEMG signals were then used for automatic speech recognition via machine learning. Sensor placement was tailored to the patient's unique anatomy, following radiation and surgery. A personalized wearable mask covering the sensors was designed using 3D scanning and 3D printing.Results: Using seven sEMG sensors on the patient's face and neck and two grounding electrodes, we recorded EMG data while he was mouthing "Tedd" and "Ed." With data from 75 utterances for each of these words, we discriminated the sEMG signal with 86.4% accuracy using an XGBoost machinelearning model. Conclusions:This pilot study demonstrates the feasibility of sEMG-based alaryngeal speech recognition, using tailored sensor placement and a personalized wearable device. Further refinement of this approach could allow translation of silently articulated speech into a synthesized voiced speech via portable devices.

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Section: Introductionmentioning

confidence: 99%

Pilot study for a novel and personalized voice restoration device for patients with laryngectomy

Rameau¹

2019

Head & Neck

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“…Unlike laryngeal phonation where the vocal folds can be observed using laryngoscopy, the whole PE segment cannot be visualized directly except for the visible neoglottis that can be seen via high-speech endoscopy 14 and videostrobosopy 15 . Therefore, the PE segment has been assessed by a number of parameters such as vibratory characteristics 6 , dimension 16 , position of the PE segment prominence related to the anterior 17 and posterior pharyngeal walls 16 , intraluminal pressure 18 , and PE geometry 19 . A range of methods have been used to investigate the characteristics of the vibrating PE segment during TE phonation including videofluoroscopy 17 , manometry 20 , and acoustic analysis 21 .…”

Section: Introductionmentioning

confidence: 99%

The relationship between biomechanics of pharyngoesophageal segment and tracheoesophageal phonation

Zhang¹,

Cook

Szczęśniak

et al. 2019

Sci Rep

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This study examined the relationship between biomechanical features of the pharyngoesophageal (PE) segment, acoustic characteristics of tracheoesophageal (TE) phonation, and patients’ satisfaction with TE phonation. Fifteen patients using TE phonation after total laryngectomy completed the Voice Symptom Scale (VoiSS) and underwent acoustic voice analysis for cepstral peak prominence (CPP) and relative intensity. High resolution manometry (HRM) combined with videofluoroscopy was used to evaluate PE segment pressure and calculate the pressure gradient (ΔP), which was the pressure difference between the upper oesophagus and a point two centimetres above the vibrating PE segment. The upper oesophageal sphincter (UOS) minimal diameters were measured by Endolumenal Functional Lumen Imaging Probe (EndoFLIP). HRM detected rapid pressure changes at the level of the 4th – 6th cervical vertebra. CPP, relative intensity, and ΔP were significant predictors of satisfactory TE phonation. ΔP was a significant predictor of CPP and intensity. Minimal UOS diameter was a significant predictor of relative intensity of TE phonation. In two patients with unsuccessful TE phonation, endoscopic dilatation subsequently restored TE phonation. These findings suggest that sufficient ΔP and large UOS diameter are required for satisfactory TE phonation. Endoscopic dilatation increasing UOS diameter may provide a new approach to treat unsuccessful TE phonation.

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“…After total laryngectomy, the interruption of the upper respiratory tract, the trauma to the surrounding nerves, and the myotomy of the cricopharyngeal muscle alters not only the high-pressure zone of the PES 1 but also the esophageal peristalsis. 4-6 The success of TE speech is related to the morphodynamic of the PES. 5…”

Section: Introductionmentioning

confidence: 99%

“…3 After total laryngectomy, the interruption of the upper respiratory tract, the trauma to the surrounding nerves, and the myotomy of the cricopharyngeal muscle alters not only the high-pressure zone of the PES 1 but also the esophageal peristalsis. [4][5][6] The success of TE speech is related to the morphodynamic of the PES. 5 To assess the morphology and physiology of the PES, different methods can be used; we have chosen 3 of them: voice perceptual analysis, high-speed camera (HSC) recording, and high-resolution videomanometry (HRVM).…”

Section: Introductionmentioning

confidence: 99%

The Pharyngoesophageal Segment After Total Laryngectomy

Búa

Olsson

Westin

et al. 2016

Ann Otol Rhinol Laryngol

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Correlation of Maximum Phonation Time and Vocal Intensity With Intraluminal Esophageal and Pharyngoesophageal Pressure in Total Laryngectomees

Abstract: The middle and distal regions of the esophagus were found to be compliant, permitting an adjustment of vocal intensity. There was no correlation between maximum phonation time and the amplitude of esophageal and pharyngoesophageal segment pressure.

Cited by 7 publications

References 27 publications

Pilot study for a novel and personalized voice restoration device for patients with laryngectomy

Pilot study for a novel and personalized voice restoration device for patients with laryngectomy

The relationship between biomechanics of pharyngoesophageal segment and tracheoesophageal phonation

The Pharyngoesophageal Segment After Total Laryngectomy

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