Auditory-perceptual scaling and quality of life in tracheoesophageal speakers

OBJECTIVES/HYPOTHESIS: The purposes of the study were to determine listeners' auditory-perceptual ratings of tracheoesophageal speakers, to determine quality of life in tracheoesophageal speakers, and to determine the potential relationship between listeners' ratings of speech and tracheoesophageal speakers' self-rated quality of life. STUDY DESIGN: Twenty-eight laryngectomized individuals who used tracheoesophageal speech as their primary mode of communication were studied. Fifteen naive listeners provided auditory-perceptual ratings. METHODS: Twenty-eight tracheoesophageal speakers (22 men and 6 women) completed a general information form, in addition to the University of Michigan Head and Neck Quality of Life (HNQOL) instrument; speakers also provided connected speech samples of a standard passage. Fifteen naive listeners evaluated the tracheoesophageal speech samples for overall speech severity, naturalness, acceptability, and pleasantness using direct magnitude estimation procedures. RESULTS: Listeners were able to discriminate among tracheoesophageal speech samples relative to the auditory-perceptual dimensions. Male tracheoesophageal speakers were judged as having significantly better, more acceptable, and more pleasant voices than women. Scores on the HNQOL instrument were determined to be higher among the group of tracheoesophageal speakers in the present study than those reported in previous studies. No significant differences were found among men and women for quality of life scores. Quality of life domains and auditory-perceptual judgments of tracheoesophageal speech were moderately correlated. CONCLUSION: Women who use tracheoesophageal speech may be differentially penalized for dimensions related to voice quality. Limitations in voice did not necessarily translate into worse overall quality of life, indicating that auditory-perceptual evaluation and quality of life questionnaires are evaluating different aspects of function after laryngectomy.