Voice rehabilitation in laryngectomees: comparison of daily-life performance of 4 types of alaryngeal speech.

BACKGROUND

We compared 4 kinds of alaryngeal speech available in Taiwan in the performance of daily-life tasks. The speech methods included pneumatic device (Taiwan tube), electrolaryngeal speech, esophageal speech, and tracheoesophageal prosthesis.

METHODS

Questionnaires covering various communication situations in daily-life tasks as well as subjective feelings about using alaryngeal speech were distributed to members of The Taiwan Laryngectomees' Association and were collected mostly in April 2000 in their annual meeting.

RESULTS

A total of 108 members responded to the questionnaire (totally 160 were questionnaires distributed). The mean age of respondents was 68.6 years, and the average time after surgery was 14.5 years. A pneumatic device was used by 58.8% of the responders, esophageal speech was used by 24.7%, an electrolarynx by 10.3%, and a tracheoesophageal prosthesis by 6.2%. No statistical difference was noted among patients using any of the 4 devices in terms of 13 communication tasks in daily life, except 4 questions such as the convenience of alaryngeal speech, embarrassment in face of strangers, the effort required to speak, and the discomfort in throat/neck/mouth when speaking. No statistical differences were noted among the 4 devices in terms of intelligibility.

CONCLUSIONS

All 4 alaryngeal speech methods can serve most of the communication functions in daily life tasks with no differences in intelligibility. Limitations in loudness and tone were common problems. It is crucial for surgeons to understand the performance of various alaryngeal speeches in daily life during rehabilitation consultations with patients.