Factors Influencing the Learning of Esophageal Speech

Keith, Robert L.; Ewert, Josephine C.; Flowers, Charles R.

doi:10.3109/13682827409011616

Cited by 15 publications

(11 citation statements)

References 7 publications

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“…In addition, patients often consider ES to be complex and tiresome and may leave the program too early . Factors affecting EST include the patient's personality, speech level prior to the operation, motivation, determination, psychological state, desire for training, limited voice therapy facilities, age, self‐confidence, family support, mental state, the ability to learn, the voice therapist's ability to teach, the level of surgery, the existence of RT history, the existence of esophageal motility disorder, and pressure on the pharyngoesophageal segment . In this study, 78% of subjects attended all sessions, which is a remarkable rate of attendance and reflects the motivation of the subjects and the therapy team.…”

Section: Discussionmentioning

confidence: 79%

“…However, no statistically significant difference between groups was observed in terms of ES proficiency. Previous studies share the idea that the most significant factors affecting EST are the patient's psychological state, desire for training, determination, and effort . Because only 18 cases were subjected to RT, no data regarding the effect of RT on EST was obtained.…”

Section: Discussionmentioning

confidence: 99%

“…It was found that age, educational background, chemotherapy experience, and the duration between operation and EST did not have any significant effect on EST. These results are similar to the results of studies by Keith et al ., Singer et al ., and Frith et al . The competence and effectiveness of members in the multidisciplinary rehabilitation team directly affects the acquisition of ES .…”

Section: Discussionmentioning

confidence: 99%

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Novel esophageal speech therapy method in total laryngectomized patients: biofeedback by intraesophageal impedance

et al. 2014

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The loss of the best communication port after total laryngectomy surgery makes speech rehabilitation an important goal. Our aim was to improve the quality of esophageal speech (ES) using online esophageal multichannel intra-luminal impedance (MII) as a new biofeedback method. Twenty-six total laryngectomized patients were included. Before ES therapy, an esophageal motility test was carried out. MII catheters were placed in all subjects who were then randomized into two groups. Group 1 included 13 cases, who were retrained according to the classical method. Group 2 included 13 cases, who were retrained according to the simplified animation of air movements within the esophagus and upper stomach resulting from the modifications of intra-esophageal air kinetics gained by MII. The level of speech proficiency was evaluated relative to pretraining levels using perceptual scales in the third and sixth months. Acoustic voice was analyzed. The number of syllables read per minute and the intelligibility of monosyllabic and dissyllabic words were calculated. In this study, MII was used for the first time in alaryngeal speech rehabilitation as a biofeedback method; an overall sufficient speech level was achieved by 68.4% at the end of therapy, whereas attendance was 90%. A statistically significant improvement was found in both groups in terms of ES level compared with the pretraining period although there was no significant difference between groups. Although we did not observe the expected difference between groups suggested by our hypothesis, MII may be used as an objective tool to show patients how to swallow and regurgitate air during training, and may thus expedite ES therapy both for the speech therapist and the patient in the future.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Novel esophageal speech therapy method in total laryngectomized patients: biofeedback by intraesophageal impedance

et al. 2014

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“…The therapeutic techniques to train the patient are devised to boost the pressure of the air through compressing it in the mouth and upper pharyngeal level, enabling the air to pass through the mouth to the esophagus by decreasing the pressure in the body of the esophagus via some breathing techniques, and to perform oral phonation by burping the air retained in the esophagus rapidly . While a common consensus in the literature has not yet been established as to the factors influencing the success of EST, their roles, and interactions with each other, among the main factors considered are preoperative information for the patient, age, physical capacity, self‐confidence, psychological state, intellectuality, socio‐economic status, daily need for communication, ability to learn, family support, a patient social environment provoking speech enthusiasm, the number and frequency of the therapy sessions, and the speech therapist's attitudes …”

Section: Discussionmentioning

confidence: 99%

Predictive value of esophageal motility test in the proficiency of esophageal speech

et al. 2014

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One method of speech rehabilitation following total laryngectomy surgery is esophageal speech therapy (EST). In this method, which has witnessed relatively low success rates at the end of therapy, identification of patients who can benefit from EST beforehand will be important for determining the appropriate method for alaryngeal speech rehabilitation and might be cost-effective, saving time and labor. To this end, this study conducted research on the feasibility of manometric data measured prior to therapy using an esophageal motility test (EMT) in order to determine the candidates most suitable for esophageal speech (ES) beforehand. A total of 51 total laryngectomy male patients who had never been subject to any kind of speech rehabilitation and had always been articulate were included in the study. Data were collected from 44 patients who completed EST, lasting for 6 months in total and consisting of 11 sessions. Manometric measures were obtained through EMT using a water-perfusion system with a Dent sleeve catheter on the patients prior to the therapy. Wepman's scale was used in order to evaluate ES proficiency. Following the therapy, in accordance with this scale, while patients whose scores was 1, 2, or 3 were considered as adequate, those whose scores were 4, 5, 6, or 7 were considered inadequate and were divided into two groups. Manometric correlations were analyzed between 17 patients (group I) who were able to perform ES at an adequate level and 27 patients (group II) who could not. No statistically significant difference between the groups could be observed in terms of average pressure generated within the upper and lower esophageal sphincters obtained through EMT, peak amplitude of esophageal body contraction pressure, contraction duration time, onset velocity, or peak velocity values. EMT conducted prior to application of EST to total laryngectomized patients did not have any value in determining the level of ES that a patient could reach. Our results also suggest that sphincter pressures or esophageal motility patterns do not have any predictive value and should not be performed.

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“…Der Vergleich von objektiv gemessener Sprechverst ä ndlichkeit (PLTT -korreliert mit Hilfsmittelnutzung) und subjektiv empfundener Beeintr ä chtigung des Sprechens (EORTC QLQ-H & N35 -korreliert nicht mit Hilfsmittelnutzung) legt nahe, dass subjektive Angaben eventuell auch in den anderen Lebensqualit ä tsbereichen mit Fremdeinsch ä tzungen differieren. So w ä re der Unterschied zu Befunden in anderen Studien erkl ä rbar, in denen der Arzt den Erfolg des Hilfsmittels einsch ä tzte und dokumentierte[7,8,24, 25] . Bekannt ist auch, dass Studien zur Wirksamkeit von einzelnen Hilfsmitteln mitunter von den Firmen co-fi nanziert werden, die das Produkt herstellen oder vertreiben, sodass es dadurch eventuell zu einem Bias in den Ergebnissen bzw.…”

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Nutzung ausgewählter Hilfsmittel durch Laryngektomierte

Schnittger

Meyer²,

Kienast³

et al. 2007

Rehabilitation

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In general the health care for laryngectomees in terms of device use can be seen as relatively good but not as optimal. Problematic is the fact that 15.5% of the patients could not acquire an adequate voice, that some devices are missed by patients despite the fact that they are available for purchase, and that some patients do not care for their tracheostoma. It could be useful to consider these findings within medical consultations.

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Factors Influencing the Learning of Esophageal Speech

Cited by 15 publications

References 7 publications

Novel esophageal speech therapy method in total laryngectomized patients: biofeedback by intraesophageal impedance

Novel esophageal speech therapy method in total laryngectomized patients: biofeedback by intraesophageal impedance

Predictive value of esophageal motility test in the proficiency of esophageal speech

Nutzung ausgewählter Hilfsmittel durch Laryngektomierte

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