Alaryngeal Speech Aerodynamics: Lower and Upper Airway Considerations

Searl, Jeff

doi:10.1007/978-3-030-04702-3_13

Cited by 4 publications

(6 citation statements)

References 111 publications

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“…Collectively, and as a likely consequence of a high-volume pulmonary driving source, the present data provide further support for the notion that assessments of accuracy in TE speakers must carefully consider the phonetic construction of stimulus materials used, as they are likely to be directly influenced by pulmonary driving pressures in the group of postlaryngectomy alaryngeal speakers [10,28,29]. Accordingly, data also suggests that a pulmonary powered TE speech system and the associated aerodynamic changes will result in resonant changes within the postlaryngectomy vocal tract, including temporal changes in the onset of voicing [27][28][29][30][31][32][33][34]. Thus, the representation of sounds within any given stimulus list must always be addressed as a potential threat to the internal and external validity of accuracy measures which are gathered from speakers.…”

Section: Introductionsupporting

confidence: 70%

“…That is, the identification of individualized patterns of production/perception may be optimized through use of distinctive features, most specifically relative to voicing and manner of production, as a point of assessment. Thus, accuracy will be stimulus dependent due to unique aerodynamic and acoustic characteristics of the TE signal [9,10,[27][28][29][30][31]33,34]. This more refined method of analysis will certainly be a reflection of how any given stimulus word list is constructed.…”

Section: Implications Of Datamentioning

confidence: 99%

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The Influence of Stimulus Composition and Scoring Method on Objective Listener Assessments of Tracheoesophageal Speech Accuracy

Doyle,

Goncharenko,

Searl

2023

Applied Sciences

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Introduction: This study investigated the influence of stimulus composition for three speech intelligibility word lists and two scoring methods on the speech accuracy judgments of five tracheoesophageal (TE) speakers. This was achieved through phonemic comparisons across TE speakers’ productions of stimuli from the three intelligibility word lists, including the (1) Consonant Rhyme Test, (2) Northwestern Intelligibility Test, and (3) the Weiss and Basili list. Methodology: Fifteen normal-hearing young adults served as listeners; all listeners were trained in phonetic transcription (IPA), but none had previous exposure to any mode of postlaryngectomy alaryngeal speech. Speaker stimuli were presented to all listeners through headphones, and all stimuli were transcribed phonetically using an open-set response paradigm. Data were analyzed for individual speakers by stimulus list. Phonemic scoring was compared to a whole-word scoring method, and the types of errors observed were quantified by word list. Results: Individual speaker variability was noted, and its effect on the assessment of speech accuracy was identified. The phonemic scoring method was found to be a more sensitive measure of TE speech accuracy. The W&B list yielded the lowest accuracy scores of the three lists. This finding may indicate its increased sensitivity and potential clinical value. Conclusions: Overall, this study supports the use of open-set, phonemic scoring methods when evaluating TE speaker intelligibility. Future research should aim to assess the specificity of assessment tools on a larger sample of TE speakers who vary in their speech proficiency.

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Section: Introductionsupporting

confidence: 70%

Section: Implications Of Datamentioning

confidence: 99%

The Influence of Stimulus Composition and Scoring Method on Objective Listener Assessments of Tracheoesophageal Speech Accuracy

Doyle,

Goncharenko,

Searl

2023

Applied Sciences

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“…The aerodynamic measurements subglottal air pressure, average flow rate, and laryngeal resistance have been used to explore sound characteristics of different alaryngeal phonations by attributing alterations in aerodynamic parameters to anatomical changes in the patients [12]. However, the most frequently examined parameters are the average fundamental frequency (F0), F0 range and perturbation, phonation intensity, vowel duration, and voice onset time [13].…”

Section: Introductionmentioning

confidence: 99%

Chaos Behavior Analysis of Alaryngeal Voices Including Esophageal and Tracheoesophageal Voices

Liu

Zhang

Chen

et al. 2022

Folia Phoniatr Logop

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Hypothesis/Objectives This study’s objective was to develop a method to the evaluate the chaotic characteristic of alaryngeal speech. The proposed method will be capable of distinguishing between normal and alaryngeal voices, including esophageal (SE) and tracheoesophageal (TE) voices. It has been previously shown that alaryngeal voices exhibit chaotic characteristics due to the aperiodicity of their signals. The proposed method will be applied for future use to quantify both chaos behavior and the difference between SE and TE voices. Study Design A total of 74 voice recordings including 34 normal and 40 alaryngeal (26 esophageal (SE) and 14 tracheoesophageal (TE)) were used in the study. Voice samples were analyzed to distinguish alaryngeal voices from normal voices and investigate different chaotic characteristics of SE and TE speech. Methods A chaotic distribution detection-based method was used to investigate the chaos behavior of alaryngeal voices. This chaos behavior was used to detect the difference between SE and TE voice types. Quantification of the chaos behavior (CB) parameter was performed. Statistical analyses were used to compare the results of the CB analysis for both the SE and TE voices. Results Statistical analysis revealed that CB effectively differentiated between all normal and alaryngeal voice types (P<0.01). Subsequent multiclass receiver operating characteristic (ROC) analysis demonstrated that CB (area under the curve) possessed the greatest classification accuracy relative to Correlation dimension (D2). Conclusions The CB metric shows strong promise as an accurate, useful metric for objective differentiation between all normal and alaryngaeal, SE and TE voice types. The CB calculations showed expected results, as SE voices have significantly more chaos behavior than TE voices, constituting substantial improvement over previous methods and becoming the first SE and TE classification method. This metric can help clinicians obtain additional acoustical information when monitoring the efficacy of treatment for patients undergoing total laryngectomies.

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“…These changes to the pulmonary and upper respiratory system have been well documented and create an additional physiological burden on an already unwell patient. [1][2][3] Because of this surgical intervention, a tracheostomy can directly impair verbal communication, especially in the initial postsurgical period which subsequently adds an extra layer of complexity to the basic functional communication needs of the patient. Complications such as mucus plugging and associated respiratory distress are not uncommon.…”

mentioning

confidence: 99%

“…Additionally, airway resistance and mucocilliary clearance are disrupted, leading to thicker, viscous mucus which can be challenging to clear from the airway. These changes to the pulmonary and upper respiratory system have been well documented and create an additional physiological burden on an already unwell patient 1‐3 . Because of this surgical intervention, a tracheostomy can directly impair verbal communication, especially in the initial postsurgical period which subsequently adds an extra layer of complexity to the basic functional communication needs of the patient.…”

mentioning

confidence: 99%

Adoption and Utilization of Heat and Moisture Exchangers (HMEs) in the Tracheostomy Patient

Kearney,

Norris,

Bertelsen

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveManagement of tracheostomized patients typically involves a conventional external humidification system (CEHS). CEHS are noisy, negatively impact patient mobility, and increases costs. Additionally, they prevent phonation and the ability to cough. Alternatively, heat and moisture exchange (HME) devices have been used in laryngectomized patients. We present an institutional quality improvement project exploring the use and efficacy of an HME device following tracheostomy.MethodsHealth care professionals and stakeholders from multiple disciplines were identified: otolaryngology, nursing, administration, case management, and speech‐language pathology. The focus was on an otolaryngology acute care nursing unit. Protocols for product acquisition, nursing education, care flowcharts, and discharge planning were established. Efficacy was assessed by tracking patient pulmonary status, nursing notes, and questionnaires.ResultsSeventy‐one tracheostomized patients were enrolled. Two patients (2.8%) were unable to tolerate the HME. There were no complications from mucous plugging or respiratory distress. Eighty‐nine percent of nursing staff surveyed preferred the use of an HME device over CEHS, particularly for ease of patient mobility. Additional favorable findings were patient satisfaction, cost savings, reduced noise, communication, and ease of discharge education and planning.DiscussionReplacing CEHS with HMEs provides distinct advantages, with a positive impact on patients, family members, and health care personnel. Resistance to changing from the traditional standard of care was alleviated with education, focused training, and positive outcomes.Implications for PracticeThese data indicate that an HME device is safe and offers advantages to both patients and nurses over traditional CEHS.

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Alaryngeal Speech Aerodynamics: Lower and Upper Airway Considerations

Cited by 4 publications

References 111 publications

The Influence of Stimulus Composition and Scoring Method on Objective Listener Assessments of Tracheoesophageal Speech Accuracy

The Influence of Stimulus Composition and Scoring Method on Objective Listener Assessments of Tracheoesophageal Speech Accuracy

Chaos Behavior Analysis of Alaryngeal Voices Including Esophageal and Tracheoesophageal Voices

Adoption and Utilization of Heat and Moisture Exchangers (HMEs) in the Tracheostomy Patient

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