Provoxweb
  • Provoxweb
  • Voice--Speech Rehab
    • Speech Therapy >
      • Introduction
      • Preoperative counseling
      • Outline of voice therapy
      • Important basic principles in voice rehabilitation in prosthetic speech
      • Some points of attention for the 'finishing touch'
      • General aspects of patient instruction
      • Problem solving
      • Conclusion
  • Pulmonary Rehab
    • Introduction
    • Heat and Moisture Exchangers (HME's) >
      • Treatment aspects
      • Prevention aspects
    • Provox HME >
      • Compliance aspects
      • Improvements in compliance
      • Improvements in voicing
      • Early post-operative pulmonary hygiene
      • Breathing resistance
      • Newest Provox HMEs
    • Treatment with inhalation medication
    • Conclusions
    • References

Closure of the membrane

Usually, the membrane closes immediately in reaction to the increased airflow when the patient attempts to speak. However, some patients tend to close the membrane first and then start to speak. This causes the impression of a slight delay and sometimes the closure of the membrane can be heard. When this is the case, it is advised to practice simultaneous closure of the membrane and start of voicing by making the patient aware of this behavior, focusing on breath support, and practice with phonation of /h/-vowel combinations and vowel onsets, followed by normal sentences.

Also, the phenomenon of a delay between closure of the membrane and start of speaking is more often seen when the patient has just started using the hands-free device. The patient then is ‘thinking’ too much about closing the valve. Usually it already helps not to think and speak more automatically.

© The Netherlands Cancer Institute - 2003-18; ISBN 90-75575-05-X