Speech and Voice after Laryngectomy: Perceptual and Acoustical Analyses of Tracheoesophageal Speech Related to Voice Handicap Index

Abstract

Objective: To perform perceptual and acoustical analyses of tracheoesophageal (TE) speech and relate these analyses to self-reported voice handicap. Methods: Recordings of 35 TE speakers were perceptually assessed by 5 speech-language pathologists. Acoustical analyses were made of voice aspects and temporal speech aspects. Self-assessments of voice were made with the Voice Handicap Index (VHI). Results: Perceptual assessment of TE speech showed significant correlations between overall degree of deviation and low speaking rate, deviant articulation, monotonous intonation, roughness and low pitch. The overall degree of deviation correlated significantly with acoustical measurements of speaking rate, articulation rate, and phrase length. Significant correlations were also found between assessed pitch and measured fundamental frequency, between assessed speaking rate and measured number of words per minute, and between assessed phrase length and measured number of syllables per breath. Self-assessments of VHI were significantly correlated with voice intensity and temporal speech aspects such as total reading time, phrase length, and percent pause time. No significant correlations were found between perceptual assessment and VHI degree. Conclusion: The listeners’ ratings of overall degree of deviation in TE speech showed relations to both voice quality and temporal aspects in speech. The TE speakers’ voice handicap degree were mainly related to changes in temporal aspects of speech.

Reliability and validity of the Italian self-evaluation of communication experiences after laryngeal cancer questionnaire

“…To the best of our knowledge, no previous studies have attempted to compare the SECEL scores with auditory perceptual measures. However, the VHI has been studied in patients with substitution voice after supracricoid laryngectomy, showing positive correlation between the General parameter of the GRBAS scale and total VHI . This datum is in agreement with our findings and suggests that even if perceptual and self‐assessment scales give independent information, a relationship between them exists.…”

“…There is minimal information on the relationship between the subjective impressions of the person with laryngeal cancer and other voice measures. Previous research has analyzed the correlation between perceptual measures, such as the GRBAS scale (G = grade of dysphonia, R = roughness, B = breathiness, A = asthenic, S = strain), and both QOL and voice‐related QOL, and only moderate correlations were found, suggesting that perceptual evaluation and QOL questionnaires evaluate different aspects of the voice. Nonetheless, because the SECEL asks the patients to rate the impact of the substitution voice on communication, it would be reasonable to expect that patient responses to these questions would relate to aerodynamic and perceptual voice measures as well as articulation scores.…”

Scientific Evidence Regarding the Quality of Life of Total Laryngectomees

“…Cancer of the larynx is prevalent among males with a mean age of more than 60 years [2][3][4]19,33,36,39,43].…”

“…Other investigators [39] analyzed the relationship between perceptive-auditory assessment, visual analog scale, and extraction of acoustic and self-assessment measures of 35 men submitted to total laryngectomy who were TEP users. There was a marked change in general voice impression, intonation, pitch, and speech slowness and rate.…”

A new proposal for evaluation of the pharyngoesophageal segment and its relation with the narrow-band spectrogram in tracheoesophageal speakers

“…Because this makes it possible to use the flow of the lung air, the TE voice approximates the speech fluency and speed of the laryngeal voice (6,7) . In the meantime, the irregular vibration of the PES, which is evident, generates a voice quality quite rough, with low pitch (8,9) and which is different, when compared with the laryngeal voice (10,11) . Because the PES is the sound source of the TE voice, it was the subject of study in diverse scientific activities that used video fluoroscopy (VF) to help comprehend its physiology.…”