Aerodynamic findings in esophageal voice.

OBJECTIVE

To define the perceptive and aerodynamic characteristics of esophageal voice in relation to different rehabilitation modalities.

DESIGN

Cross-sectional study comparing perceptive and aerodynamic variables in 3 subject groups.

SETTING

Referral center.

SUBJECTS: A total of 19 subjects who underwent total laryngectomy were divided into groups A and B. Group A consisted of 13 subjects (who required speech therapy)-8 good speakers (subset A(1) who were >80% intelligible) and 5 mediocre speakers (subset A(2) who were <70% intelligible). Group B consisted of 6 subjects with a tracheoesophageal prosthesis (who were >90% intelligible).

MAIN OUTCOME MEASURES: Perceptive variables included phonatory pauses and stomal noise. Aerodynamic variables included maximum phonation time, phonatory flow, phonatory volume, postphonatory volume, intensity, and articulatory pressure.

RESULTS

Phonatory pauses and stomal noise statistically differentiated group A from group B and good speakers from mediocre speakers. Phonation time, phonatory volume, and phonatory flow were statistically higher in group B subjects compared with group A subjects. Postphonatory volume was significantly higher in group A. Intraoral pressure and postphonatory volume were statistically higher in subset A(2) subjects compared with subset A(1) subjects while maximum phonation time was significantly higher in subset A(1) subjects compared with subset A(2) subjects.

CONCLUSIONS

In subset A(1) subjects a positive ratio between phonatory volume and phonatory flow was maintained with an adequate phonation time. In subset A(2) subjects a reduced phonatory volume was associated with a more rapid dispersion of phonatory flow, lower duration of phonation, and frequent pauses; stomal noise and consonant hyperarticulation worsened the voice performance in this group. In group B subjects the positive ratio between phonatory volume and phonatory flow represented the prerequisite of speech without frequent pauses.