Search

Purpose: Our aim was to assess the different voice prostheses (VPs) to identify the most efficient, safest, patient-tailored, longest lifetime, and inexpensive VPs and assess the different factors affecting their quality. Method: In September 2017, 15 databases were searched to include all randomized controlled trials. A new search was done in May 2019 to include all other study design articles, which include all the new-era VPs subtypes. Network meta-analysis (NMA) was applied to all 27 outcomes, besides NMA overall and partial order setting was done by using Hasse scatter plots. p values were used in NMA, where the best VPs are approaching one and the least approaches zero. Meta-analysis was done for the rest of the outcomes. Results: Two hundred one articles were eligible for inclusion in our study (N = 11,918). Provox-2 was significantly the most efficient and safest device concerning the most patient preference (odds ratio [OR] = 33.88 [0.65, 1762.24]; p = .92), the least dislodgement (risk ratio [RR] = 0.27 [0.13, 0.57]; p = .79), the least airflow resistance (RR = 0.42 [0.08, 2.11]; p = .84), the least granulation formation (RR = 0.73 [0.02, 26.32]; p = .60), and the least VPs' inaccurate size (RR = 0.77 (0.23, 2.61); p = .66). Heat and moisture exchanger addition showed a significant increase in maximum phonation time and breathing experience, with p values (1 and .59), respectively. While heat and moisture exchanger addition showed a significant decline in stoma cleaning frequency, coughing frequency, forced expectoration, sputum production, sleeping problems, and loosening of adhesive, with p values (.99, .72, .69, .96, 1, and 0.96), respectively, Groningen low resistance and Nijdam were considered the worst devices with both overall mean p value of .44. Conclusions: Provox-2 is considered the best choice as being the most preferable for patients, with the least airflow resistance, dislodgment, granulation formation, and prosthesis inaccurate size. Groningen low resistance and Nijdam were considered the worst devices according to our analysis. Supplemental Material: https://doi.org/10.23641/asha. 14802903, Laryngeal cancer is the most common malignancy of the head and neck, ranking the 19th globally with an estimated 13,150 new cases in the United States in 2018, as reported [...]

Purpose: The electrolarynx (EL) is a widely used device for alaryngeal speech, but it requires manual operation and produces voice that typically has a constant fundamental frequency. An electromyographically controlled EL (EMG-EL) was designed and implemented to provide hands-free control with dynamic pitch modulation. Method: Three participants who underwent total laryngectomy surgery and 4 participants with normal voice were trained to produce EMG-EL speech through a multiple-baseline, successive-stage protocol. Baseline performance was established through 3 testing probes, followed by multiple hour-long training sessions. Results: At the end of the training, all participants learned to initiate, sustain, and terminate EMG-EL activation in correspondence with articulation, and most were able to modulate the pitch to produce intonational contrasts. After completing the testing/ training protocol, 1 of the 3 participants who underwent total laryngectomy was encouraged to independently use the EMG-EL at his residence. This participant sustained his performance for an additional 6 weeks and also used the EMG-EL successfully to communicate over the phone. Conclusions: Our findings suggest that some participants with laryngectomies and vocally normal individuals can learn to produce hands-free speech using the EMG-EL device within a few hours and that significant additional gains in device control (particularly pitch modulation) are attainable through subsequent training sessions. KEY WORDS: alaryngeal speech treatment, artificial larynx, electromyography, laryngectomy, speech, Electrolarynx (EL) speech continues to play a major role in laryngectomy rehabilitation; multiple studies report that more than half of patients use an EL for verbal communication after total laryngectomy [...]

The purpose of this study was to determine the psychophysical character and validity of auditory-perceptual ratings of naturalness and overall severity for tracheoesophageal (TE) speech. This was achieved through use of direct magnitude estimation (DME) and equal-appearing interval (DEAN) scaling procedures. Twenty adult listeners judged speech naturalness and overall severity from connected speech samples produced by 20 adult male TE speakers. A comparison of DME- and EAI-scaled judgments yielded a metathetic continuum for naturalness and a prothetic continuum for overall severity. These data provide support for the use of either DME or EAI scales in auditory-perceptual ratings of naturalness, but they provide support only for DME scales in judging overall severity for TE speech. The present results suggest that the nature of perceptual phenomena (prothetic vs. metathetic) for TE speakers is consistent with findings for the same dimensions produced by normal laryngeal speakers. These data also support a need for further study of perceptual dimensions associated with TE voice and speech in order to avoid the inappropriate and invalid use of EAI scales frequently found in diagnosis, assessment, and evaluation of this clinical population. KEY WORDS: tracheoesophageal speech, perceptual scaling, alaryngeal speech, naturalness, severity., Despite a long history in the psychophysical character literature (cf. Stevens, 1975) for the application of direct magnitude estimation (DME), the DME method is re-emerging in relation to perceptual judgments [...]

Summary: This study sought to compare formant frequencies estimated from natural phonation to those estimated using two methods of artificial laryngeal stimulation: (1) stimulation of the vocal tract using an [...]