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Original Article
June 2001

Aerodynamic Findings in Esophageal Voice

Author Affiliations

From the Institute of Otorhinolaryngology, Ateneo "Federico II," University of Naples, Naples, Italy (Dr Motta); and the Institute of Otorhinolaryngology, Catholic University of the Sacred Heart, Rome, Italy (Drs Galli and Di Rienzo). Dr Motta is now with the Institute of Otorhinolaryngology, Catholic University of the Sacred Heart, Rome.

Arch Otolaryngol Head Neck Surg. 2001;127(6):700-704. doi:10.1001/archotol.127.6.700

Objective  To define the perceptive and aerodynamic characteristics of esophageal voice in relation to different rehabilitation modalities.

Design  Cross-sectional study comparing perceptive and aerodynamic variables in 3 subject groups.

Setting  Referral center.

Subjects  A total of 19 subjects who underwent total laryngectomy were divided into groups A and B. Group A consisted of 13 subjects (who required speech therapy)—8 good speakers (subset A1 who were >80% intelligible) and 5 mediocre speakers (subset A2 who were <70% intelligible). Group B consisted of 6 subjects with a tracheoesophageal prosthesis (who were >90% intelligible).

Main Outcome Measures  Perceptive variables included phonatory pauses and stomal noise. Aerodynamic variables included maximum phonation time, phonatory flow, phonatory volume, postphonatory volume, intensity, and articulatory pressure.

Results  Phonatory pauses and stomal noise statistically differentiated group A from group B and good speakers from mediocre speakers. Phonation time, phonatory volume, and phonatory flow were statistically higher in group B subjects compared with group A subjects. Postphonatory volume was significantly higher in group A. Intraoral pressure and postphonatory volume were statistically higher in subset A2 subjects compared with subset A1 subjects while maximum phonation time was significantly higher in subset A1 subjects compared with subset A2 subjects.

Conclusions  In subset A1 subjects a positive ratio between phonatory volume and phonatory flow was maintained with an adequate phonation time. In subset A2 subjects a reduced phonatory volume was associated with a more rapid dispersion of phonatory flow, lower duration of phonation, and frequent pauses; stomal noise and consonant hyperarticulation worsened the voice performance in this group. In group B subjects the positive ratio between phonatory volume and phonatory flow represented the prerequisite of speech without frequent pauses.