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The present article aims to identify the optimal cutoff score and the diagnostic accuracy for the English version of Speech Handicap Index (SHI) to screen out individuals with and without speech disorders in daily life. In this cross-sectional cohort study, a volunteer sample of 104 adult patients after total laryngectomy and 99 healthy controls in the United States completed the English version of SHI online questionnaire. Sensitivity and specificity were computed for a range of cut-off values using the Receiving Operating Characteristics (ROC) analysis to establish an optimal cutoff point for the SHI. Other measures of diagnostic accuracy, such as likelihood ratios (LR), positive predictive values (PPV), and negative predictive values (NPV) were also computed. Patients after total laryngectomy obtained a higher score than the healthy controls on the mean scores of SHI. According to the ROC analysis, an optimal cutoff score of 17 points determined by Youden index was identified on the head and neck cancer population with a sensitivity of 92.31%, specificity of 92.31%, PPV of 90.60%, NPV of 91.75%, LR + of 9.14, and LR- of 0.09. The cutoff score of the English version of SHI applied on the English-speaking population in the United States demonstrated promising diagnostic accuracy. [ABSTRACT FROM AUTHOR]

To conduct a systematic review of the use and results of the Provox®VegaTMXtraSealTM in the prevention of periprosthetic leakage and to propose a management protocol for this voice prosthesis. Systematic search based on the PRISMA Statement during February 2020. Keywords were double flange, periprosthetic leakage, voice prosthesis, and laryngectomy. Four articles with 315 voice prosthesis (94 XtraSeal and 221 controls) in 55 patients were found. The XtraSeal mean duration was 114.28 ± 73.2 (CI 95%, 98.29–130.26) days compared to 102.98 ± 17.74 (CI 95%, 100.62–105.35) days of the control group. Out of 266 replacements, endoprosthetic leakage was the most frequent cause in both groups (62.41%). Periprosthetic leaks were less frequent in the XtraSeal (9.62%) than in the control group (22.43%). The XtraSeal could be effective in preventing periprosthetic leakage and lengthening the time between replacements. Studies with a robust methodology are necessary to confirm these results. Managing voice prosthesis is complex and requires a multidisciplinary and systematic approach by experienced professionals to reduce replacements and complications. Incorrect placement of the XtraSeal could cause a foreign body reaction and consequently inflammation, extrusion, or pressure lesions. The Tower of Hercules protocol: (1) Measurement of the tracheoesophageal fistula using the Provox® Measure, (2) Minimization of XtraSeal slack by avoiding the complete visualization of the prosthesis' blue ring, (3) Nasofibroscopic examination of the oesophageal wall confirming both flanges are in correct position; could prevent or minimize complications derived from the use of the XtraSeal. [ABSTRACT FROM AUTHOR]

Currently, there is limited information on listeners' perceptions of an individual with a laryngectomy. The purpose of this study is to determine whether listeners have different impressions of a laryngectomized speaker's personality based on mode of alaryngeal speech. Fifty-one listeners were presented with a reading passage produced by three male, alaryngeal speakers. Listeners were instructed to rate each speaker's personality and overall speech on a seven-point scale. Results showed that listeners' perceptions of personality were not affected by mode of alaryngeal speech, although listener's perceptions of overall speech were shown to be significantly affected by mode. Results, however, should be interepreted with caution due to small sample size and limited speaker representation. A portion of this information was previously presented at the American Speech Language and Hearing Association (ASHA) Annual Convention, Chicago, IL, November 13-15, 2003. [ABSTRACT FROM AUTHOR]

Supracricoid laryngectomy (SCL) is an efficient surgical procedure for the treatment of selected laryngeal carcinoma, presently being performed not only in Europe but also in North America. The functional goals of the technique are voice and swallowing without a permanent tracheostoma. Perceptual and acoustic voice characteristics after SCL have been reported by different authors, but self-assessment data together with subjective and objective data have only been reported for a small number of subjects. Twenty male subjects, with a mean age of 71 years (range: 51–82 years) who underwent a SCL at least one year before our observation, were included in the study. Each subject underwent a flexible laryngoscopy and his voice was perceptually rated using the GRBAS scale. Objective examination included: maximum phonation time (MPT), voice spectrograms and syllable diadochokinesis on a single breath. Finally, each subject assessed his own voice using the Voice Handicap Index (VHI). The mean values of the GRBAS scale were respectively 2.4, 2.6, 2.4, 0.8, 0.5, 0.8. Mean MPT was 7.5 s, while for voice spectrograms the mean value of the Yanagihara scale was 3.7. Mean syllable diadochokinesis appeared as 3.3 syllables/s. Mean value of the VHI was 29.9. Subjective and objective data show a severely dysphonic voice after SCL; self-assessment data, on the contrary, reveal only moderate functional and emotional consequences. While perceptual, aerodynamic and acoustic data are in line with previous reports, self-assessment data were less severe in our subjects compared to what appears in the literature. It is concluded that self-assessment explores a different dimension of the patient's voice and that even if a severe dysphonia is present the consequences on everyday oral communication are only moderate. [ABSTRACT FROM AUTHOR]

The aim of the research was to compare voice and speech in three groups of alaryngeal speakers: 1) patients using esophageal speech, 2) patients with electro-acoustical speech aids and 3) patients with voice prostheses. Acoustic analysis and pronunciation tests were used for the analysis. Acoustic analysis included fundamental frequency, maximum phonation time, jitter, shimmer and intensity. Pronunciation parameters were: phonetic block duration, number of syllables in a phonetic block, rate of speech, maximum number of syllables in a phonetic block and rate of articulation in a maximal phonetic block. Our results demonstrated the advantages of tracheoesophageal puncture with implantation of a voice prosthesis over the other two techniques of alaryngeal speech. Voice and pronunciation with voice prostheses were closer to normal in many parameters: fundamental frequency, maximum phonation time, jitter, shimmer, duration of a phonetic block, number of syllables in a phonetic block, rate of speech and rate of articulation in maximal phonetic block. [ABSTRACT FROM AUTHOR]

Some vocal characteristics were compared in two groups of examinees: patients after near-total laryngectomy and a control group of healthy examinees. Acoustic analysis was carried out using Multi Dimensional Voice Program and Spectra LAB program. Analyzed parameters were: fundamental frequency, the range of fundamental frequency, maximum phonation time, jitter, shimmer, noise to harmonic ratio, voice turbulence index, degree of voice breaks and intensity of voice. We found that voice after near-total laryngectomy had normal mean fundamental frequency, larger range of fundamental frequency, jitter and shimmer were high, as were noise to harmonic ratio and voice turbulence index. Maximum phonation time was short and intensity was lower compared to control group. Degree of voice breaks was significant in near-total laryngectomy group. [ABSTRACT FROM AUTHOR]

Vocal characteristics were compared in two groups of patients who were operated on due to laryngeal cancer. One group was composed of patients after near-total laryngectomy and the other after total laryngectomy followed by tracheoesophageal puncture with implantation of Provox 2 prosthesis. Acoustic analysis was carried out using the EZ Voice Plus program and included the following parameters: fundamental frequency, jitter, shimmer, harmonic to noise ratio, range of fundamental frequency, maximal phonation time and intensity. [ABSTRACT FROM AUTHOR]