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Aerodynamic Findings in Esophageal Voice
Sergio Motta, MD;
Iacopo Galli, MD;
Lino Di Rienzo, MD
Arch Otolaryngol Head Neck Surg. 2001;127:700-704.
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.
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.
Corresponding author and reprints: Sergio Motta, MD, Clinica Otorinolaringoiatrica,
Università Cattolica del Sacro Cuore, Largo A. Gemelli, 00168 Rome,
Italy (e-mail: sermotta{at}Yahoo.it).
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