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Voice Prosthesis (voice + prosthesis)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

A Thin Tracheal Silicone Washer to Solve Periprosthetic Leakage in Laryngectomies: Direct Results and Long-Term Clinical Effects,

THE LARYNGOSCOPE, Issue 4 2008
Frans J. M. Hilgers MD
Abstract Objectives: Assessment of the immediate results and long-term clinical effects of a thin silicone washer placed behind the tracheal flange of voice prostheses to treat periprosthetic leakage. Patients and Methods: Three year retrospective analysis of 32 laryngectomized patients with 107 periprosthetic leakage events (PLEs). Custom-made silicone washers (outer diameter 18 mm, inner diameter 7.5 mm, thickness 0.5 mm) were placed behind the tracheal flange either in combination with prosthesis replacement or later. Results: There was immediate resolution of periprosthetic leakage in 88 PLEs (median, 38 d; mean, 53 d; range, 8,330 d) and in 6 PLEs with the washer still in situ at the date of analysis (median, 75; mean, 97 d; range, 38,240 d). There was no resolution for periprosthetic leakage in 13 PLEs. Thus, in total, 94 of 107 PLEs (88%) were successfully resolved. In 29 of 32 (91%) patients, the washer resolved the problem at least in one PLE successfully. Twelve of 32 patients, including all 3 with washer failures, also required other interventions to ultimately solve the problem. The vast majority of patients (80%) did not consider placement of the washer to be inconvenient. Conclusions: In consideration of the high success rate and limited inconvenience for patients, this simple thin silicon washer application provides a good first option for the treatment of periprosthetic leakage. [source]

Assessment of alaryngeal speech using a sound-producing voice prosthesis in relation to sex and pharyngoesophageal segment tonicity

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2006
M. van der Torn MD
Abstract Background. A pneumatic artificial sound source incorporated in a regular tracheoesophageal shunt valve may improve alaryngeal voice quality. Methods. In 20 laryngectomees categorized for sex and pharyngoesophageal segment tonicity, a prototype sound-producing voice prosthesis (SPVP) is evaluated for a brief period and compared with their regular tracheoesophageal shunt speech. Results. Perceptual voice evaluation by an expert listener and acoustical analysis demonstrate a uniform rise of vocal pitch when using the SPVP. Female laryngectomees with an atonic pharyngoesophageal segment gain vocal strength with the SPVP. Exerted tracheal pressure and airflow rate are equivalent to those required for regular tracheoesophageal shunt valves. However, communicative suitability and speech intelligibility deteriorate by the SPVP for most patients. Tracheal phlegm clogging the SPVP is a hindrance for most patients. Conclusions. The SPVP raises vocal pitch. Female laryngectomees with an atonic or severely hypotonic pharyngoesophageal segment can benefit from a stronger voice with the SPVP. © 2005 Wiley Periodicals, Inc. Head Neck28: 400,412, 2006 [source]

Multidimensional assessment of female tracheoesophageal prosthetic speech

CLINICAL OTOLARYNGOLOGY, Issue 6 2006
R. Kazi
Objective:, The objective of this study was to undertake a multidimensional assessment of female tracheoesophageal prosthetic speech. Study Design:, A cross-sectional cohort study. Setting:, Head and Neck Unit in a tertiary oncology referral centre. Patients:, Ten female and 10 male total laryngectomy patients with no signs of recurrence and using voice prosthesis were compared to 10 normal female speakers. Intervention(s):, Electroglottographic and acoustic analysis of voice parameters for both sustained vowel /i/ and connected speech, perceptual evaluation using GRBAS (with 2 experienced raters) and questionnaire assessment using the University of Washington Quality of Life and the Voice Handicap Index. Statistical analysis was done using the Statistical Package for Social Sciences, (v. 14, SPSS Inc., Chicago III). Results:, Median age of the female larygectomy patiemts was 65 years (range: 41-81), that of male laryngectomees was 66.5 years (range: 40-79) and that of the normal female subjects was 47.5 years (range: 35-72). All electroglottographic, acoustic parameters and GRBAS ratings of the female laryngectomy patients were significantly worse as compared with the normal female subjects. The median fundamental frequency (111.8 Hz) was comparable to male tracheoesophageal speakers (115.8 Hz). Mean composite University of Washington Quality of Life score and overall Voice Handicap Index score was 79.3(12.5) and 47.5(27.6) for the female laryngectomy patients and for the males was 81.2 (9.6) and 39.4(18.7). Conclusions:, Gender frequency differences as seen in normal subjects are lost following a laryngectomy operation as evidenced by electroglottographic and perceptual data. Although the quality of life scores are comparable to the male tracheoesophageal speakers, they exhibit a greater voice handicap as compared to their male counterparts. [source]