Aerodynamics of the Pseudo-Glottis (original) (raw)
Related papers
Aerodynamic and Sound Intensity Measurements in Tracheoesophageal Voice
ORL, 2007
Furthermore, the average airflow rate as a function of the sound pressure levels could be determined. Results: In our population, 6 out of 7 patients showed a positive relationship between trans-source airflow and generated sound intensity. We compared our prosthesis pressure drop values with in vitro data and found that there are some differences, possibly due to difference in age of the prosthesis and physiological circumstances in vivo. The overall contribution of the voice prosthesis to the airway resistance depends on the level of phonation and the type of device. In our patient group it is apparent that the pharyngoesophageal (PE) segment has the greatest share of the total pressure drop, especially at higher airflow rates. We measured a 27% pressure drop in airflow over the voice prosthesis. Different tracheo stoma occlusion methods did not have any effect on the aerodynamics and sound intensity. One patient that had had a jejunal graft for reconstruction showed, not unexpectedly, extremely different aerodynamic values. We were unable to define optimal airflow rates or optimal resistance values for sound production in the PE segment. Conclusion: The aerodynamic characteristics of voice production in laryngectomized patients with voice prostheses are determined by both prosthetic factors and PE segment tissue factors. In our patient group the PE segment is responsible for the greatest pressure drop. We found no significant difference in pressure drop and sound intensity for different tracheostoma occlusion methods.
Acoustic analysis of tracheo-oesophageal voice in male total laryngectomy patients
The Annals of The Royal College of Surgeons of England, 2011
INTRODUCTION The aim of this study was to test the null hypothesis that voice parameters of post-laryngectomy patients using tracheo-oesophageal (TO) prosthetic valves are similar to those of normal laryngeal subjects. METHODS Thirty total laryngectomy patients and thirty normal controls were subjected to acoustic analysis of single voice recordings using a sustained vowel. Acoustic parameters including fundamental frequency, jitter, shimmer, harmonics-to-noise ratio and maximum phonation time were analysed. RESULTS Poorer values were found as well as larger variability for all the voice parameters for the total laryngectomy patients using TO voice compared with those of normal subjects. There were statistically significant differences (p<0.05) for all studied parameters between the TO and normal speech. CONCLUSIONS Alaryngeal speech with TO voice prosthesis is not yet comparable to laryngeal speech.
Objective assessment of tracheoesophageal and esophageal speech using acoustic analysis of voice
Collegium antropologicum, 2012
The aim of this study was to analyze the voice quality of alaryngeal tracheoesophageal and esophageal speech, and to determine which of them is more similar to laryngeal voice production, and thus more acceptable as a rehabilitation method of laryngectomized persons. Objective voice evaluation was performed on a sample of 20 totally laryngectomized subjects of both sexes, average age 61.3 years. Subjects were divided into two groups: 10 (50%) respondents with built tracheoesophageal prosthesis and 10 (50%) who acquired esophageal speech. Testing included 6 variables: 5 parameters of acoustic analysis of voice and one parameter of aerodynamic measurements. The obtained data was statistically analyzed by analysis of variance. Analysis of the data showed a statistically significant difference between the two groups in the terms of intensity, fundamental frequency and maximum phonation time of vowel at a significance level of 5% and confidence interval of 95%. A statistically significan...
Behavior of the Cricopharyngeal Segment During Esophageal Phonation in Laryngectomized Patients
Journal of Voice, 2007
Background: After total laryngectomy, the interruption of the upper digestive tube and the section of the cricopharyngeal segment alter the highpressure zone of the pharyngoesophageal transition, which will not only start to have a digestive function, but also be stimulated to take on the production of voice and speech. The pressure observed in the cricopharyngeal segment seems to act as a critical factor for the development of esophageal sound production, and manometry is the procedure capable of quantifying the pressure observed in this region. Objective: The objective of the current study was to assess the upper esophageal sphincter pressure in laryngectomized patients who are either successful or unsuccessful esophageal speakers, both at rest and during esophageal phonation, using manometry. Methods: Twenty laryngectomized persons aged 32 to 83 years (mean, 44.2 years) were submitted to evaluation by a speech pathologist and divided into two groups, ie, successful esophageal speakers (N 5 12) and unsuccessful esophageal speakers (N 5 8), according to a scale validated by Wepman et al (1953). The upper esophageal sphincter (UES) pressure was assessed by manometry both at rest and during the following voice emissions in Portuguese: the vowel ''a,'' the monosyllable ''pa,'' and the sentence ''papai papou pipoca.'' The amplitude, the duration of the pressure wave, and the area under the curve were measured. Results: At rest, the mean UES pressure was 11.83 mm Hg for successful esophageal speakers and 9.92 mm Hg for unsuccessful esophageal speakers, with no significant difference between groups; the mean for the two groups as a whole was 11.06 mm Hg. During the voice and speech sequence tests, no significant difference was observed when the emissions in Portuguese of ''a,'' ''pa,'' and the sentence were analyzed separately. Conclusion: As the pressure observed at rest did not differ between the successful esophageal speakers and the unsuccessful esophageal speakers, and the amplitude, the duration of the pressure wave, and the area under the
Medical & Biological Engineering & Computing, 1998
Experimental results on voice prostheses used for the rehabilitation of patients that have lost their vocal function after total laryngectomy are presented. The purpose is to evaluate the difference in aerodynamic behaviour between Staffieri voice prosthesis and other commercial valves (Groningen standard, Groningen tow pressure, Panje, Provox). Two different equipments for flow-rate measurement were designed and built to compare the performance of the valves. The valves have been experimentally tested under different conditions of airflow through the valve and tracheal side pressure. The data allow calculation of the airflow resistance, the parameter usually used to compare the performance of valves. The valves have also been experimentally tested under different conditions of fluid flow through the valve and oesophageal side pressure (reverse flow). Comparing the airflow resistance of Staffieri valves of different length L and different angular extension of the razor-thin slit c~, it has been observed that the parameter c~ has a significant influence on the characteristics, while the effect of the length L is negligible. The airflow resistance of the Provox, Groningen low pressure and Staffieri c~ = 270 ~ valves are comparable; the Panje and Staffieri c~ = "180 ~ have similar behaviour; while the Groningen Standard is comparable to the Staffieri ~ = 90 ~ Regarding reverse flow, it is pointed out that for most of the valves (Staffieri and commercial valves), at different oesophageal pressures the fluid flow is smaller than the flow that can be tolerated by patients without giving problems.
A First Comparative Study of Oesophageal and Voice Prosthesis Speech Production
EURASIP Journal on Advances in Signal Processing, 2009
The purpose of this work is to evaluate and to compare the acoustic properties of oesophageal voice and voice prosthesis speech production. A group of 14 Italian laryngectomized patients were considered: 7 with oesophageal voice and 7 with tracheoesophageal voice (with phonatory valve). For each patient the spectrogram obtained with the phonation of vowel /a/ (frequency intensity, jitter, shimmer, noise to harmonic ratio) and the maximum phonation time were recorded and analyzed. For the patients with the valve, the tracheostoma pressure, at the time of phonation, was measured in order to obtain important information about the "in vivo" pressure necessary to open the phonatory valve to enable speech.
European Archives of Oto-Rhino-Laryngology, 2015
The purpose of this study was to evaluate the air kinetics of well-and poor-speaking patients and their upper (UES) and lower (LES) esophageal sphincter pressures. The esophageal speech capability of 23 total laryngectomy patients was assessed with the Wepman scale. LES and UES points and pressures were measured, and air kinetics were compared. All patients were male, with an average age of 58 years. Both the LES and UES pressures were not statistically different between good-speaking and poor-speaking patients (p [ 0.05). The ability to speak was estimated only by looking at tracings. Good speakers are able to retain air successfully and on a long-term basis between the upper and lower esophageal sphincters. During short and/or rapid speech, these patients are able to rapidly suck and then expel the air from their upper esophagus. During long speeches, after sucking the air into their distal esophagus, they used the air in the upper part of the esophagus during the speech, only later seeming to fill the lower esophagus with the air as a possible reserve in the stomach. It has been shown that the basic requirement for speaking is the capacity to suck and store the air within the esophagus. For successful speech, the air should be stored inside the esophagus. MII technology contributes to our understanding of speech kinetics and occupies an important place in patient training as a biofeedback technique.
Speech results with tracheoesophageal voice prosthesis after total laryngectomy
JPMA. The Journal of the Pakistan Medical Association, 2005
To assess the success rate of tracheoesophageal voice prosthesis as the primary mode of voice rehabilitation in patients after total laryngectomy. Medical record files of 35 patients subjected to total laryngectomy were reviewed for determining success or failure of the voice prosthesis. The indicators used were quality of speech and utility of the device. Subsequent complications that developed were also assessed. In addition other factors taken into consideration were pharyngeal myotomy, use of radiation, and timing of replacement. All thirty five patients (n=35) had prosthesis placed at the time of laryngectomy. The success rate at one month and four months follow up was 85.18%. Of note, 3 patients were lost to follow-up, 3 patients died of disease and 2 had recurrence of disease. Our results confirm the effectiveness, longevity and safety of the tracheoesophageal voice prosthesis for speech rehabilitation following total laryngectomy.
2016
this study examined the relationship between biomechanical features of the pharyngoesophageal (pe) segment, acoustic characteristics of tracheoesophageal (te) phonation, and patients' satisfaction with te phonation. Fifteen patients using te phonation after total laryngectomy completed the Voice symptom scale (Voiss) and underwent acoustic voice analysis for cepstral peak prominence (Cpp) and relative intensity. High resolution manometry (HRM) combined with videofluoroscopy was used to evaluate pe segment pressure and calculate the pressure gradient (Δp), which was the pressure difference between the upper oesophagus and a point two centimetres above the vibrating PE segment. the upper oesophageal sphincter (Uos) minimal diameters were measured by endolumenal Functional Lumen Imaging probe (endoFLIp). HRM detected rapid pressure changes at the level of the 4th-6th cervical vertebra. CPP, relative intensity, and ΔP were significant predictors of satisfactory TE phonation. ΔP was a significant predictor of CPP and intensity. Minimal UOS diameter was a significant predictor of relative intensity of te phonation. In two patients with unsuccessful te phonation, endoscopic dilatation subsequently restored TE phonation. These findings suggest that sufficient Δp and large Uos diameter are required for satisfactory te phonation. endoscopic dilatation increasing Uos diameter may provide a new approach to treat unsuccessful te phonation.
Design and in vitro Testing of a Voice-Producing Element for Laryngectomized Patients
The International Journal of Artificial Organs, 2000
A voice-producing element has been developed to improve speech quality after laryngectomy. The design process started with the formulation of a list of requirements. The lip principle has the best potential for fulfilling the requirements. A numerical model was made to find the optimal geometry of an element based on the lip principle. Extensive in vitro tests were performed to check all requirements. For this a test set-up with realistic acoustic and aerodynamic properties was developed. Results show that the protruding lip length dominates fundamental frequency, cross-sectional area dominates flow resistance and relation between flow and fundamental frequency. Most requirements have been fullfilled; both for males and females a potentially good functioning prototype could be selected. Clinical experiments will be performed to confirm the quality of the voice-producing prosthesis.