Improvements in voicing
The improved intelligibility and easier stoma occlusion, as reported by the patients using the Provox HME, were recently studied in 21 laryngectomized patients.11 Two different stoma occlusion conditions, i.e. direct digital occlusion of the stoma (by thumb or finger), and digital occlusion (by finger) via the Provox HME were compared. For both conditions acoustical analyses of voice quality (various pitch, amplitude, tremor and harmonicity measures) were performed on a sustained /a/, the mean maximum phonation time was calculated, and a phonetogram was made to establish the dynamic loudness range. Acoustical analysis was possible in 13 of the 21 voices (for the other voices the pitch was too low or the voice was too aperiodic), but no statistical significant differences were found for any of the acoustical parameters studied. However, the maximum phonation time was significantly longer and the dynamic loudness range was significantly larger, under the Provox HME occlusion condition. The maximum phonation time showed a relevant improvement in 57% of the patients, while the dynamic loudness range showed a relevant improvement in 35% of the patients. In total, 75% of the patients benefit of an improvement in one or both of these speech characteristics when using the Provox HME occlusion.
It can be concluded that optimal stoma occlusion by means of a specialized device has a positive influence on two relevant parameters of prosthetic voice production: maximum phonation time and dynamic loudness range.
It can be concluded that optimal stoma occlusion by means of a specialized device has a positive influence on two relevant parameters of prosthetic voice production: maximum phonation time and dynamic loudness range.