Invitational Round Table
“Evidence-based Voice and Speech Rehabilitation in Head and Neck Cancer”

Amsterdam, The Netherlands
May 15-16, 2008

Tracheoesophageal Speech with Manual Versus Automatic Stoma Occlusion: a Multidimensional Comparison

Annelies Labaere (1), Jan Vanderwegen (2), Frans Debruyne (1)

(1) Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Belgium
(2) Antwerp University Hospital, Department of Otorhinolaryngology, Antwerp, Belgium

Objectives: The objective of this study was to make a qualitative comparison between tracheoesophageal speech with manual stoma occlusion and handsfree tracheoesophageal speech with the Provox FreeHands device.

Patients/Materials and Methods: Both manual and handsfree tracheoesophageal speech were compared in 13 patients who were regular users of Provox FreeHands for at least four months. Evaluation of speech material consisted of objective analysis using the KayPentax CSL, perceptual ratings by a group of experienced listeners and patients own perceptual judgment. In addition, data concerning user-friendliness, additional values and inconveniences of the FreeHands device were gathered using questionnaires. The Voice Handicap Index (VHI) was used to evaluate the relation between voice related QOL and method of stoma occlusion. Therefore a control group of TE-speakers, who did not use handsfree speech, was selected.

Results: Objective analysis revealed significant differences (p< 0.05) for parameters fluency (i.e. the number of syllables produced on one intake of breath) and maximal phonation time, to the detriment of handsfree speech. There were no significant differences found for the dynamic characteristics Perceptual judgments of running speech were rated higher in the manual occlusion condition for most patients, but there were interrater differences. Subjective impressions showed that the majority of patients preferred handsfree speech to manual stoma occlusion, noticeably for voice quality, fatigability, attractiveness and feelings of self-confidence. Major inconveniences of handsfree speech were a significantly decreased duration of sticker adhesion, the occurrence of disturbing noises and the need for continued effort. The VHI scores were significantly higher in the group of handsfree speakers compared to the control group.

Conclusions: This clinical study showed that in selected patients the Provox FreeHands shows important subjective benefits. Improvements however are necessary to make the device a useful rehabilitation device for a larger group of laryngectomized patients.

Keywords: tracheoesophageal speech, handsfree speech, automatic tracheostoma valve

Full Paper

Bibliographic reference.  Labaere, Annelies / Vanderwegen, Jan / Debruyne, Frans (2008): "Tracheoesophageal speech with manual versus automatic stoma occlusion: a multidimensional comparison", In EVSR-2008, 115-122.