alaryngeal speech


Summary: Methods of enabling a patient without a larynx or with a non-functional larynx to produce voice or speech. The methods may be pneumatic or electronic.

Top Publications

  1. Eadie T. The ICF: a proposed framework for comprehensive rehabilitation of individuals who use alaryngeal speech. Am J Speech Lang Pathol. 2003;12:189-97 pubmed
  2. Tsai T, Chang S, Guo Y, Chu P. Voice rehabilitation in laryngectomees: comparison of daily-life performance of 4 types of alaryngeal speech. J Chin Med Assoc. 2003;66:360-3 pubmed
    We compared 4 kinds of alaryngeal speech available in Taiwan in the performance of daily-life tasks. The speech methods included pneumatic device (Taiwan tube), electrolaryngeal speech, esophageal speech, and tracheoesophageal prosthesis...
  3. van der Torn M, van Gogh C, Verdonck de Leeuw I, Festen J, Verkerke G, Mahieu H. Assessment of alaryngeal speech using a sound-producing voice prosthesis in relation to sex and pharyngoesophageal segment tonicity. Head Neck. 2006;28:400-12 pubmed
    ..Tracheal phlegm clogging the SPVP is a hindrance for most patients. The SPVP raises vocal pitch. Female laryngectomees with an atonic or severely hypotonic pharyngoesophageal segment can benefit from a stronger voice with the SPVP. ..
  4. van Rossum M, de Krom G, Nooteboom S, Quené H. "Pitch" accent in alaryngeal speech. J Speech Lang Hear Res. 2002;45:1106-18 pubmed
    ..Speakers with no control over F0 apparently relied on an alternative pitch system to convey accents and other pitch movements. ..
  5. Hoffmann T, Heisterkamp M, Angerstein W, Scheckenbach K, Bier H, Horlitz S. [Prosthesis for the dysmorphic tracheostoma after laryngectomy]. Laryngorhinootologie. 2006;85:86-9 pubmed
  6. Fukumoto M, Ota H, Arima H. Ventilator weaning using a fenestrated tracheostomy tube with a speaking valve. Crit Care Resusc. 2006;8:117-9 pubmed
    ..A fenestrated tracheostomy tube is usually used to improve daily activities of patients with tracheostomies, but might be worth trying for difficult ventilator weaning. ..
  7. ten Hallers E, Marres H, van der Houwen E, Jansen J, Rakhorst G, Schutte H, et al. Experimental results of the tracheoesophageal tissue connector for improved fixation of shunt valves in laryngectomized patients. Head Neck. 2006;28:982-9 pubmed
    ..The TE-TC is a new device with potential in the solution for fixation-related problems in tracheoesophageal voice rehabilitation. ..
  8. Gorur K, Ozcan C, Unal M, Ozkul M. A new and simple modification of the prosthetic voice restoration technique. J Laryngol Otol. 2003;117:365-7 pubmed
    ..An easy and safe method is described for the insertion of a Provox voice prosthesis using a Yankauer tonsil suction tube and an antrum trocar with an irrigation cannula. ..
  9. Reynolds M, Isaacs Duvall C, Haddox M. A comparison of learning curves in natural and synthesized speech comprehension. J Speech Lang Hear Res. 2002;45:802-10 pubmed
    ..These results suggest that high-quality synthesized speech, such as DECtalk, can be useful in many human factors applications. ..

More Information


  1. Pind J. Rate-dependent perception of aspiration and pre-aspiration in Icelandic. Q J Exp Psychol A. 1996;49:745-64 pubmed
    ..The differences in the behaviour of these speech cues are related to their different positions in the syllable. ..
  2. Law I, Ma E, Yiu E. Speech intelligibility, acceptability, and communication-related quality of life in Chinese alaryngeal speakers. Arch Otolaryngol Head Neck Surg. 2009;135:704-11 pubmed publisher
    To investigate (1) speech intelligibility and acceptability in using 4 different alaryngeal speech methods: esophageal (ES), electrolaryngeal (EL), pneumatic device (PD), and tracheosophageal (TE) speech; and (2) communication-related ..
  3. Liu H, Ng M, Wan M, Wang S, Zhang Y. The effect of tonal changes on voice onset time in Mandarin esophageal speech. J Voice. 2008;22:210-8 pubmed
    ..This may be related to their use of pharyngoesophageal (PE) segment as another sound source. SE speakers appear to take a shorter time to start PE segment vibration compared to NL speakers using the vocal folds for vibration. ..
  4. Happ M, Roesch T, Kagan S. Communication needs, methods, and perceived voice quality following head and neck surgery: a literature review. Cancer Nurs. 2004;27:1-9 pubmed
    ..Clinical issues and technological advancements in augmentative and alternative communication applicable to the in-hospital period are discussed, and research implications are presented. ..
  5. Reynolds M, Fucci D. Synthetic speech comprehension: a comparison of children with normal and impaired language skills. J Speech Lang Hear Res. 1998;41:458-66 pubmed
    ..Implications these results might have for theories of the underlying cause of specific language impairment are discussed. ..
  6. Drager K, Reichle J. Effects of discourse context on the intelligibility of synthesized speech for young adult and older adult listeners: applications for AAC. J Speech Lang Hear Res. 2001;44:1052-7 pubmed
    ..These results have direct implications for AAC system message transmission. ..
  7. Murphy P, McGuigan K, Walsh M, Colreavy M. Investigation of a glottal related harmonics-to-noise ratio and spectral tilt as indicators of glottal noise in synthesized and human voice signals. J Acoust Soc Am. 2008;123:1642-52 pubmed publisher
    ..One of the tilt measures and GHNR' are shown to provide statistically significant differentiating power over a conventional HNR estimator. ..
  8. Saikachi Y, Stevens K, Hillman R. Development and perceptual evaluation of amplitude-based F0 control in electrolarynx speech. J Speech Lang Hear Res. 2009;52:1360-9 pubmed publisher
    ..The current study provides preliminary support for amplitude-based control of F0 in EL speech. ..
  9. Hunt A, Howard D, Morrison G, Worsdall J. A real-time interface for a formant speech synthesizer. Logoped Phoniatr Vocol. 2000;25:169-75 pubmed
    ..The result is a novel hand-controlled speech synthesizer which is not command/phoneme based, but is rather more like a continually controlled musical instrument where the speech sounds are shaped in real-time. ..
  10. Bertelson P, Frissen I, Vroomen J, de Gelder B. The aftereffects of ventriloquism: patterns of spatial generalization. Percept Psychophys. 2006;68:428-36 pubmed
    ..This dependence of generalization patterns on the direction of the discordance imposed during adaptation has not been reported before, perhaps because the experimental designs in use did not allow its observation. ..
  11. Choinzonov E, Balatskaia L, Krasavina E, Chuzhevskaia S. [Quality of life in laryngectomized patients after vocal rehabilitation]. Vopr Onkol. 2008;54:211-5 pubmed
    ..Physical, psychological, social and symptomatic parameters were followed through the stages of vocal rehabilitation. On completion of therapy, patients spoke freely; 68% of them recovered their social and professional status. ..
  12. Van As Brooks C, Koopmans van Beinum F, Pols L, Hilgers F. Acoustic signal typing for evaluation of voice quality in tracheoesophageal speech. J Voice. 2006;20:355-68 pubmed
    ..Results showed that the four acoustic signal types form a good basis for performing more acoustic analyses and give a good impression of the overall quality of the voice. ..
  13. Kawahara H, Tatematsu H, Yamataka K, Sakurai T, Yamamoto T. [Surgical voice restoration after pharyngolaryngoesophagectomy]. Nihon Geka Gakkai Zasshi. 2001;102:659-62 pubmed
    ..The resultant speech is acceptable in most patients. ..
  14. Meltzner G, Hillman R. Impact of aberrant acoustic properties on the perception of sound quality in electrolarynx speech. J Speech Lang Hear Res. 2005;48:766-79 pubmed
    ..Such additional factors need to be clearly identified and remedied before EL speech can be made to more closely approximate the sound quality of normal natural speech. ..
  15. Tervonen H, Back L, Juvas A, Räsänen P, Makitie A, Sintonen H, et al. Automatic speaking valve in speech rehabilitation for laryngectomized patients. Eur Arch Otorhinolaryngol. 2005;262:816-20 pubmed
    ..The FreeHands HME is a useful additional device in a selected group of laryngectomized patients. Total laryngectomy did not lower patients' HRQoL notably. ..
  16. Sussman H, Bessell N, Dalston E, Majors T. An investigation of stop place of articulation as a function of syllable position: a locus equation perspective. J Acoust Soc Am. 1997;101:2826-38 pubmed
    ..The decline in acoustic lawfulness of syllable-final stops is discussed in terms of coarticulatory interactions and expected perceptual correlates. ..
  17. Liu H, Wan M, Wang S. Features of listeners affecting the perceptions of Mandarin electrolaryngeal speech. Folia Phoniatr Logop. 2005;57:9-19 pubmed
    ..In addition, a preliminary study was presented for the perceptions of the four Mandarin tones. Higher percent correct identification was found for the high-level tone compared to the other three tones. ..
  18. Stiglmayr M, Schwarz R, Klamroth K, Leugering G, Lohscheller J. Registration of PE segment contour deformations in digital high-speed videos. Med Image Anal. 2008;12:318-34 pubmed publisher
    ..Numerical experiments show that the implemented alternate convex search algorithm produces robust results which is demonstrated at the example of five high-speed recordings of laryngectomee subjects. ..
  19. Stepp C, Heaton J, Hillman R. Post-laryngectomy speech respiration patterns. Ann Otol Rhinol Laryngol. 2008;117:557-63 pubmed
  20. Kubert H, Stepp C, Zeitels S, Gooey J, Walsh M, Prakash S, et al. Electromyographic control of a hands-free electrolarynx using neck strap muscles. J Commun Disord. 2009;42:211-25 pubmed publisher
  21. Cavalot A, Magnano M, Nazionale G, Rosso S, Ferrero V, Cortesina G. [The use of indwelling phonatory valve in the rehabilitation of laryngectomized patients: preliminary results in 30 patients]. Acta Otorhinolaryngol Ital. 1997;17:109-14 pubmed
    ..The results of the present study are in line with those presented by other authors. In particular, the immediate success rate was 83% while the long-term success rate reached 96%. ..
  22. Eadie T. Application of the ICF in communication after total laryngectomy. Semin Speech Lang. 2007;28:291-300 pubmed
    ..A concluding case example illustrates how all of these concepts can be applied by speech-language pathologists who provide post-laryngectomy rehabilitation. ..
  23. Hagen R. [Surgical voice restoration following total laryngectomy]. HNO. 2005;53:602-11 pubmed
  24. Jain A, Parker A. Groningen valve change in difficult cases. J Laryngol Otol. 2005;119:629-30 pubmed
    ..A difficult Groningen valve change is one of the problems frequently encountered in the post-laryngectomy patient. A safe and simple technique for this procedure is described. ..
  25. Saito H, Fujieda S, Ohtsubo T, Tsuda G, Saito T, Shibamori Y, et al. Tracheoesophageal shunt method with omohyoid muscle loop for voice restoration. Arch Otolaryngol Head Neck Surg. 2003;129:321-3 pubmed
    ..The indication for this method is preferably glottic laryngeal cancer. ..
  26. Cornu A, Vlantis A, Elliott H, Gregor R. Voice rehabilitation after laryngectomy with the Provox voice prosthesis in South Africa. J Laryngol Otol. 2003;117:56-9 pubmed
    ..The Provox voice prosthesis provides good voice rehabilitation following total laryngectomy, with minimal complications, in the population served by Tygerberg Hospital. ..
  27. Lichtenberger G. Simple and safe puncture technique for voice prosthesis implantation. Otolaryngol Head Neck Surg. 2003;128:835-40 pubmed
    ..The advantage of the ET puncture is that it is simple and safe and that the back wall of the pharynx or esophagus cannot be damaged. Using the ET puncture technique, the possibility of complications is eliminated. ..
  28. Zraick R, Liss J. A comparison of equal-appearing interval scaling and direct magnitude estimation of nasal voice quality. J Speech Lang Hear Res. 2000;43:979-88 pubmed
    ..Additionally, there is a discussion of methodological issues for future research and the implications of the findings for clinical and research purposes. ..
  29. Kasperbauer J, Thomas J. Voice rehabilitation after near-total laryngectomy. Otolaryngol Clin North Am. 2004;37:655-77 pubmed
    ..The resulting myomucosal shunt provides a prosthesis-free method of voice rehabilitation. This review presents indications, technique, and speech rehabilitation for a near-total laryngectomy. ..
  30. Saito M, Kinishi M, Amatsu M. Acoustic analyses clarify voiced-voiceless distinction in tracheoesophageal speech. Acta Otolaryngol. 2000;120:771-7 pubmed
    ..TE speakers with low intelligibility of [p] had lower values of VOT during [p] production compared with those with high intelligibility. It is concluded that these characteristic acoustic cues reflect voicing ability in TE speech. ..
  31. Hamadé R, Hewlett N, Scanlon E. A quantitative and qualitative evaluation of an automatic occlusion device for tracheoesophageal speech: the Provox FreeHands HME. Clin Linguist Phon. 2006;20:187-93 pubmed
    ..The principal disadvantage appeared to be a decrease in base-plate seal duration. The results suggest that, for some clients, the FreeHands valve is a useful option for use alongside manual occlusion. ..
  32. Bohnenkamp T, Stowell T, Hesse J, Wright S. Speech breathing in speakers who use an electrolarynx. J Commun Disord. 2010;43:199-211 pubmed publisher
    ..of a decoupling of the respiratory system from speech following a total laryngectomy and subsequent alaryngeal speech rehabilitation...
  33. Kosztyła Hojna B, Rogowski M, Łuczaj J, Kasperuk J. [The voice and speech quality in laryngectomy patients rehabilitated with second generation voice prosthesis]. Pol Merkur Lekarski. 2008;25:230-5 pubmed
    ..Examination findings confirm better voice quality obtained in rehabilitation with second generation voice prostheses as compared to oesophageal voice and speech resulting from natural rehabilitation process. ..
  34. Lemon J, Lewin J, Martin J, Chambers M. Custom modification of the Blom-Singer tracheostoma valve housing. J Prosthodont. 2003;12:17-20 pubmed
    ..A punch biopsy instrument is used to cut uniform holes around the housing device to allow for permeation of the silicone mixture for better mechanical adherence of the materials. ..
  35. Kazi R, Singh A, Al Mutairy A, De Cordova J, O Leary L, Nutting C, et al. Electroglottographic analysis of valved speech following total laryngectomy. Logoped Phoniatr Vocol. 2008;33:12-21 pubmed publisher
    ..Using these parameters, TO speech is significantly different from normal speech and is highly variable. This methodology has enormous potential for further investigations in laryngectomees and other patients with head and neck cancer. ..
  36. Ramírez M, Ferriol E, Doménech F, Llatas M, Suarez Varela M, Martínez R. Psychosocial adjustment in patients surgically treated for laryngeal cancer. Otolaryngol Head Neck Surg. 2003;129:92-7 pubmed
    ..Information collected in this way may facilitate improved rehabilitation and thus better quality of life. ..
  37. Peng Y, Liao J, Fan J, Ye Q. [Pharyngeal plexus neurectomy for voice restoration of alaryngeal]. Zhonghua Er Bi Yan Hou Ke Za Zhi. 2000;35:298-9 pubmed
    ..Voice restoration was achieved in 15 cases after pharyngeal plexus neurectomy, the successful rate was 93.75%. It is feasible to replace pharyngeal myotomy by nerve plexus neurectomy and raise the voice rehabilitation rate. ..
  38. Eadie T, Doyle P. Direct magnitude estimation and interval scaling of naturalness and severity in tracheoesophageal (TE) speakers. J Speech Lang Hear Res. 2002;45:1088-96 pubmed
  39. Koscielny S. [Voice and speech dysfunction. Reconstructive procedures after total laryngectomy]. Laryngorhinootologie. 2005;84 Suppl 1:S221-7 pubmed
  40. Bremke M, Werner J, Lichtenberger G, Folz B. [Chronic aspiration secondary to a Staffieri fistula: successful therapy with Provox voice prosthesis]. Laryngorhinootologie. 2007;86:798-801 pubmed
    ..Through the insertion of a voice prosthesis aspiration could be stopped and voice was immediately restored. ..
  41. Kazi R, Singh A, Venkitaraman R, Sayed S, Rhys Evans P, Harrington K. Is electroglottography-based videostroboscopic assessment of post-laryngectomy prosthetic speech useful?. J Cancer Res Ther. 2009;5:85-92 pubmed publisher
    ..Our observations suggest that from the standpoint of functional voice, saliva and the LVV had statistically significant effect in determining voice quality. ..
  42. Dayangku Norsuhazenah P, Baki M, Mohamad Yunus M, Sabir Husin Athar P, Abdullah S. Complications following tracheoesophageal puncture: a tertiary hospital experience. Ann Acad Med Singapore. 2010;39:565-4 pubmed
    ..TEP has become an integral part in the rehabilitation of a laryngectomee. However, management of the frequent complications related to TEP requires specific efforts and specialistic commitments in order to treat them. ..
  43. Dupuis P, Guertin L, Rainville M, Prud homme D, Lavigne F. Montreal's experience with Cyranose heat and moisture exchanger use in 15 laryngectomized patients. J Otolaryngol. 2007;36:208-12 pubmed
    ..Seven patients dropped out of the trial, mainly because of adhesive-related issues. Laryngectomized patients from the Montreal area could benefit from Cyranose artificial nose following an adaptation period during our cold winter. ..
  44. Tack J, Rakhorst G, van der Houwen E, Mahieu H, Verkerke G. In vitro evaluation of a double-membrane-based voice-producing element for laryngectomized patients. Head Neck. 2007;29:665-74 pubmed
    ..Functional restoration of the voice after laryngectomy with a double-membrane VPE appears to be a feasible concept for female laryngectomized patients with a hypotonic, or atonic pharyngoesophageal segment. ..
  45. Truong A, Truong D, Gillenwater A, Rozner M. Gastric aspiration in patients with a laryngectomy stoma: is it possible?. J Clin Anesth. 2006;18:557-8 pubmed
  46. Ramachandran K, Arunachalam P, Hurren A, Marsh R, Samuel P. Botulinum toxin injection for failed tracheo-oesophageal voice in laryngectomees: the Sunderland experience. J Laryngol Otol. 2003;117:544-8 pubmed
    ..Out of the three patients who were treated for hypertonic voice, two did derive some benefit from the procedure. One patient developed a hypotonic voice, which lasted for a few months. ..
  47. Globlek D, Stajner Katusic S, Musura M, Horga D, Liker M. Comparison of alaryngeal voice and speech. Logoped Phoniatr Vocol. 2004;29:87-91 pubmed
    ..of tracheoesophageal puncture with implantation of a voice prosthesis over the other two techniques of alaryngeal speech. Voice and pronunciation with voice prostheses were closer to normal in many parameters: fundamental ..
  48. Kazi R, Singh A, Mullan G, Venkitaraman R, Nutting C, Clarke P, et al. Can objective parameters derived from videofluoroscopic assessment of post-laryngectomy valved speech replace current subjective measures? An e-tool-based analysis. Clin Otolaryngol. 2006;31:518-24 pubmed
    ..Our observations suggest that this interesting concept has limitations. While objective and quantifiable data can be obtained using videofluoroscopy in laryngectomees, only a few correlate with each other and with voice quality. ..
  49. Bellandese M, Lerman J, Gilbert H. An acoustic analysis of excellent female esophageal, tracheoesophageal, and laryngeal speakers. J Speech Lang Hear Res. 2001;44:1315-20 pubmed
    ..Significant differences were found between LA speakers and both alaryngeal groups for all variables, with the exception of mean F0 (reading). ..
  50. Motta S, Galli I, Di Rienzo L. Aerodynamic findings in esophageal voice. Arch Otolaryngol Head Neck Surg. 2001;127:700-4 pubmed
    ..In group B subjects the positive ratio between phonatory volume and phonatory flow represented the prerequisite of speech without frequent pauses. ..
  51. Lancioni G, Singh N, O Reilly M, Sigafoos J, Oliva D, Baccani S. Teaching 'Yes' and 'No' responses to children with multiple disabilities through a program including microswitches linked to a vocal output device. Percept Mot Skills. 2006;102:51-61 pubmed
    ..General implications of the findings were discussed. ..
  52. Schlosser R, Blischak D. Effects of speech and print feedback on spelling by children with autism. J Speech Lang Hear Res. 2004;47:848-62 pubmed
    ..The implications for understanding the learning characteristics of children with autism, as well as those for practice and further research are derived. ..
  53. ten Hallers E, Marres H, Rakhorst G, Hagen R, Staffieri A, van der Laan B, et al. Difficulties in the fixation of prostheses for voice rehabilitation after laryngectomy. Acta Otolaryngol. 2005;125:804-13 pubmed
    ..Speaking and coughing cause pressure increases, which often result in mucous leakage and disconnection of the valve and/or HME filter. Recommendations are made for future improvements in fixation techniques. ..