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

Hyptonicity of the neoglottis

In case of hypotonicity of the neoglottis (characterized by a breathy, whispery, aphonic voice sound) might become more obvious when using a handsfree device. When using digital occlusion of the stoma the finger pressure sometimes supports the esophagus and approximates the esophageal walls in order to create a voice sound. When those patients start using a handsfree device, voice quality might decrease. Applying digital pressure on the esophagus usually helps, but then speech is not handsfree anymore. To keep speech handsfree, consider using a custom made pressure band or using a Dan Kelly pressure band. In some patients, speaking softer and at a lower pitch improves voice quality and sometimes a slight change of head position causes approximation of the esophageal walls and thereby improves voice quality.

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