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Introduction: The Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) is a 35-item patient-reported questionnaire developed to address the communication needs of patients with laryngectomies. The aim was to translate, cross-culturally adapt, and validate the Croatian version. Methods: The SECEL was translated from English by two independent translators and back-translated by a native speaker, after which it was approved by an expert committee. The Croatian version of the Self-Evaluation of Communication Experiences after Laryngectomy questionnaire (SECEL:HR) was filled in by 50 laryngectomised patients who had completed their oncological treatment a year prior to inclusion in the study. Patients also filled in the Voice Handicap Index (VHI) and the Short Form Health Survey (SF-36) on the same day. All patients completed the SECEL:HR twice, the second time being 2 weeks after the initial test. Maximum phonation time and diadochokinesis of articulation organs were used for objective assessment. Results: Among the Croatian patients, the questionnaire was well-accepted and demonstrated good test-retest reliability and internal consistency for two out of three subscales. The correlations between VHI, SF-36, and SECEL:HR were moderate to strong. There were no significant differences between patients who are using oesophageal speech, tracheoesophageal speech, or the electrolarynx based on the SECEL:HR. Conclusion: Preliminary findings of the research indicate that the Croatian version of the SECEL has sufficient psychometric qualities, high reliability, and good internal consistency, with a Cronbach's alpha of 0.89 for the total score. The Croatian version of SECEL can be recommended as a reliable and clinically valid measure for the assessment of substitution voices in Croatian-speaking patients. [ABSTRACT FROM AUTHOR]

Hypothesis/Objectives: This study's objective was to develop a method to evaluate the chaotic characteristic of alaryngeal speech. The proposed method will be capable of distinguishing between normal and alaryngeal voices, including esophageal (SE) and tracheoesophageal (TE) voices. It has been previously shown that alaryngeal voices exhibit chaotic characteristics due to the aperiodicity of their signals. The proposed method will be applied for future use to quantify both chaos behavior (CB) and the difference between SE and TE voices. Study Design: A total of 74 voice recordings including 34 normal and 40 alaryngeal (26 SE and 14 TE) were used in the study. Voice samples were analyzed to distinguish alaryngeal voices from normal voices and to investigate different chaotic characteristics of SE and TE speech. Methods: A chaotic distribution detection-based method was used to investigate the CB of alaryngeal voices. This CB was used to detect the difference between SE and TE voice types. Quantification of the CB parameter was performed. Statistical analyses were used to compare the results of the CB analysis for both the SE and TE voices. Results: Statistical analysis revealed that CB effectively differentiated between all normal and alaryngeal voice types (p < 0.01). Subsequent multiclass receiver operating characteristic (ROC) analysis demonstrated that CB (area under the curve) possessed the greatest classification accuracy relative to correlation dimension (D2). Conclusions: The CB metric shows strong promise as an accurate, useful metric for objective differentiation between all normal and alaryngaeal, SE and TE voice types. The CB calculations showed expected results, as SE voices have significantly more CB than TE voices, constituting substantial improvement over previous methods and becoming the first SE and TE classification method. This metric can help clinicians obtain additional acoustic information when monitoring the efficacy of treatment for patients undergoing total laryngectomies. [ABSTRACT FROM AUTHOR]

Background/Aim: The purpose of this study was to provide preliminary data concerning the effect of clear speech (CS) on Cantonese alaryngeal speakers' intelligibility. Methods: Voice recordings of 11 sentences randomly selected from the Cantonese Sentence Intelligibility Test (CSIT) were obtained from 31 alaryngeal speakers (9 electrolarynx [EL] users, 10 esophageal speakers and 12 tracheoesophageal [TE] speakers) in habitual speech (HS) and CS. Two naïve listeners orthographically transcribed a total of 1,364 sentences. Results: Significant effects of speaking condition on speaking rate and CSIT scores were observed, but no significant effect of alaryngeal communication methods was noted. CS was significantly slower than HS by 0.78 syllables/s. Esophageal speakers demonstrated the slowest speech rate when using CS, while EL users demonstrated the largest decrease in speaking rate when using CS compared to HS. TE speakers had the highest CSIT scores in HS (listener 1 = 81.4%; listener 2 = 81.3%), and esophageal speakers had the highest CSIT scores in CS (listener 1 = 87.5%; listener 2 = 89.7%). EL users experienced the largest increase in intelligibility while using CS compared to HS (9.1%) followed by esophageal speakers (8.9%) and TE speakers (1.4%). Conclusion: Preliminary data indicate that CS may significantly affect Cantonese alaryngeal speakers' speaking rate and intelligibility. However, intelligibility appeared to vary considerably across speakers. Further research involving larger, heterogeneous groups of speakers and listeners alongside longer and more refined CS training protocols should be conducted to confirm that CS can improve Cantonese alaryngeal speakers' intelligibility. [ABSTRACT FROM AUTHOR]

Background: Successful speech rehabilitation has a great impact on the quality of life in totally laryngectomized patients. Objectives: The aim of this paper was to compare the self-assessed voice handicap of totally laryngectomized patients with two different methods of alaryngeal speech – esophageal (ES) and tracheoesophageal speech (TES). Method: The research comprised 83 totally laryngectomized, disease-free patients, split into two groups. The first group included 43 participants with successfully rehabilitated ES, and the second group included 40 participants with successfully established TES after secondary implantation of Provox 2TM voice prosthesis. All subjects filled in the Serbian version of the Voice Handicap Index (VHI-30). The results (overall score and three VHI subscales) were analyzed and compared with those of the subjects of both groups. The impact of age in the subgroups (<65 years old and ≥65 years old) and previous irradiation on the examined VHI values were also analyzed. Results: The median value of the overall VHI score in the participants with TES was 29.03 ± 23.479 (range: 0–97), and in the participants with ES it was 64.51 ± 21.089 (range: 19–99). The VHI scores (overall and three VHI subscales) were significantly higher in participants with ES compared to those with TES (p < 0.01), indicating a larger voice handicap. No significant difference was found in the overall VHI score and VHI subgroups in terms of age subgroups and previous irradiation (p > 0.05). Conclusions: Our data reveal a significantly higher voice handicap in participants with ES compared to the TES group, with a large interindividual variation within both groups. VHI values are not significantly different between the two age subgroups, nor are they significantly influenced by irradiation. [ABSTRACT FROM AUTHOR]

Background/Aims: This study examined the effect of clear speech on vowel productions by electrolaryngeal speakers. Method: Ten electrolaryngeal speakers produced eighteen words containing /i/, /ɪ/, /ɛ/, /æ/, /eɪ/, and /oʊ/ using habitual speech and clear speech. Twelve listeners transcribed 360 words, and a total of 4,320 vowel stimuli across speaking conditions, speakers, and listeners were analyzed. Analyses included listeners' identifications of vowels, vowel duration, and vowel formant relationships. Results: No significant effect of speaking condition was found on vowel identification. Specifically, 85.4% of the vowels were identified in habitual speech, and 82.7% of the vowels were identified in clear speech. However, clear speech was found to have a significant effect on vowel durations. The mean vowel duration in the 17 consonant-vowel-consonant words was 333 ms in habitual speech and 354 ms in clear speech. The mean vowel duration in the single consonant-vowel words was 551 ms in habitual speech and 629 ms in clear speech. Conclusion: Finding suggests that, although clear speech facilitates longer vowel durations, electrolaryngeal speakers may not gain a clear speech benefit relative to listeners' vowel identifications. [ABSTRACT FROM AUTHOR]

Background/Aims: The aims of this study were (1) to determine locations of increased effort in the body when talking using tracheoesophageal speech (TES); (2) to compare talking effort for participants using TES and those using laryngeal speech; (3) to compare tongue-palate contact pressure during talking for TES and laryngeal speech; and (4) to assess the relationship between talking effort and articulatory contact pressure (ACP). Methods: This cohort comparison study included 16 individuals using TES and 10 using laryngeal speech. Participants rated talking effort on a visual analog scale and then rated effort in the lungs, throat, oral cavity, brain (cognitive) and arm/shoulder. ACP for /t/, /d/, and /n/ produced in sentences was measured using a pressure sensor on the alveolar ridge. Results: Factor analysis of effort ratings across body locations by participants using TES revealed two latent variables associated with non-voice production locations and voice production. Ratings of effort and ACP were statistically significantly higher in participants using TES. The correlation between overall talking effort and ACP was strong and statistically significantly. Conclusions: The effort ratings suggest adults with functional TES experience talking as more effortful than adults with a larynx. Some increased effort was focused in the voice production process, but regions outside of voicing were also implicated. [ABSTRACT FROM AUTHOR]

Objectives: The present study investigated the articulatory contact pressure during the production of bilabial plosives by esophageal (ES), tracheoesophageal (TE), and laryngeal speakers. Methods: The peak contact pressure (PCP) during bilabial plosive production of /CVCVCVCVCV/ syllable strings of /p/ and /ph/ was obtained from 10 ES, 10 TE, and 10 laryngeal speakers of Cantonese. PCP values were obtained by using a pressure transduction system (Iowa Oral Performance Instrument) during speech production. Results: The results showed that ES speakers exhibited a significantly greater PCP value than TE and laryngeal speakers, as revealed by cheek muscle compression force. In addition, the unaspirated bilabial plosive /p/ was associated with a greater PCP than its aspirated counterpart /ph/. Conclusion: The current findings might support the hypothesis of over-exaggerated speech for better intelligibility among alaryngeal speakers. In addition, the increased oral muscular effort could be associated with a compensatory strategy for maintaining a high intraoral pressure or the unique air intake by ES speakers. [ABSTRACT FROM AUTHOR]

Objective: Tracheoesophageal (TE) prosthetic voice is one of the voice restoration options for individuals who have undergone a total laryngectomy. Aerodynamic analysis of the TE voice provides insight into the physiological changes that occur at the level of the neoglottis with voice prosthesis in situ. The present study is a systematic review and meta-analysis of sub-neoglottic pressure (SNP) measurement in TE speakers by direct and indirect methods. Patients and Methods: The screening of abstracts and titles was carried out for inclusion of articles using 10 electronic databases spanning the period from 1979 to 2016. Ten articles which met the inclusion criteria were considered for meta-analysis with a pooled age range of 40-83 years. Results: The pooled mean SNP obtained from the direct measurement method was 53.80 cm H2O with a 95% confidence interval of 21.14-86.46 cm H2O, while for the indirect measurement method, the mean SNP was 23.55 cm H2O with a 95% confidence interval of 19.23-27.87 cm H2O. Conclusion: Based on the literature review, the various procedures followed for direct and indirect measurements of SNP contributed to a range of differences in outcome measures. The meta-analysis revealed that the "interpolation method" for indirect estimation of SNP was the most acceptable and valid method in TE speakers. [ABSTRACT FROM AUTHOR]

Objective: Despite the many studies on tracheoesophageal (TE) speech, the actual vibratory characteristics of the neoglottis in TE speech are not known. The present study examined the neoglottal vibratory pattern of Cantonese TE speakers by comparison with the glottal waveform produced by laryngeal speakers. Subjects and Methods: Eight superior TE and 8 laryngeal speakers of Cantonese participated in the study. All speakers were instructed to produce the vowels /i, ᴂ, a, ᴐ, u/ 3 times, and both acoustic and aerodynamic signals were recorded. While the airflow signals were later inverse-filtered to obtain the neoglottal and glottal waveforms, the acoustic signals were analyzed to obtain vowel formants, which were used as inputs to inverse filtering. Aerodynamic parameters including open quotient (OQ), speed quotient (SQ), and area under the curve (AUC) were compared between TE and laryngeal speakers. -Results: Results revealed that TE speakers exhibited comparable OQ and AUC, but significantly reduced SQ when compared with laryngeal speakers. Conclusions: Both inverse-filtered airflow signals associated with TE and laryngeal speech of Cantonese appear to be triangular in shape, indicating the opening, closing and closed phases of the (neo)glottis. However, neoglottal waveforms are highly variable. Such variability and inconsistency in neoglottal waveforms might be related to the lack of complete control over the neoglottis in TE speakers. [ABSTRACT FROM AUTHOR]

AbstractObjective:The present study determines the acoustical and perceptual differences between alaryngeal and laryngeal speakers of Cantonese in the production of Cantonese vowels. Subjects and Methods:Formant frequencies (F1 and F2) associated with eight Cantonese vowels (/i, y, 3, a, q, $, œ, u/) produced by 40 alaryngeal (10 esophageal, 10 tracheoesophageal, 10 with pneumatic artificial larynx, 10 electrolaryngeal) and 10 laryngeal speakers were obtained. To assess how formants affect vowel perception, the vowels were identified by 20 naïve listeners, based on which confusion matrices were established. Results:Spectral analysis revealed that F1 and F2 values of Cantonese vowels produced by the alaryngeal speakers were significantly higher than those produced by laryngeal speakers, with the exception of F2 of /3/, /i/ and /y/ produced by alaryngeal speakers using pneumatic artificial larynx, and /3/ produced by electrolaryngeal speakers. Conclusion:The acoustic findings suggest a general shortening of the effective vocal tract length for resonance in alaryngeal speakers after laryngectomy. Percent correct identification of vowels from the perceptual experiment indicated similar error patterns in vowel identification between alaryngeal and laryngeal speaker groups. Among the different alaryngeal speaker groups, naïve listeners tended to perceive the vowels produced by electrolaryngeal speakers more accurately.Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

A correction is presented to the article "Articulatory Contact Pressure during Bilabial Plosive Production in Esophageal and Tracheoesophageal Speech" which appeared in the 2019 issue.