• Phonetics and Speech Sciences
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• v.4 no.3
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• pp.143-149
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• 2012

The purpose of this study is to investigate the speech rate of an esophageal speech group that is capable of vocalization after surgery. The subjects in this experiment were 10 male esophageal speakers and 10 male laryngeal speakers. Each group read a reading passage that was recorded by a DAT recorder (Rolando, EDIROL R-09). These records were analyzed by using CSL (Computerized Speech Lab, model 4150). The results were as follows: (1) the overall speech rate of esophageal speech was 2.50 SPS (syllable per second) while the overall speech rate of laryngeal speech was 4.23 SPS. (2) The articulatory rate of esophageal speech was 3.14 SPS (syllable per second) while the articulatory rate of laryngeal speech was 4.75 SPS. Speech rates as well as articulatory rates of esophageal speech were significantly lower than laryngeal speech. These differences between the two groups may be due to reduced efficiency of airflows across the pharyngeal-esophageal segment for esophageal speakers when compared to airflow through the glottis for laryngeal speakers. These results would provide a guideline in speech rates for esophageal speakers in clinical settings.

• Speech Sciences
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• v.10 no.3
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• pp.7-27
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• 2003

Esophageal Speech uses the esophageal air during phonation. Fluent esophageal speakers frequently intake air in oral communication, but unskilled esophageal speakers are difficult with swallowing lots of air. The purpose of this study was to investigate the difference of acoustic characteristics of vowel and consonants production according to the speech proficiency level in esophageal speech. 13 normal male speakers and 13 male esophageal speakers (5 unskilled esophageal speakers, 8 skilled esophageal speakers) with age ranging from 50 to 70 years old. The stimuli were sustained /a/ vowel and 36 meaningless two syllable words. Used vowel is /a/ and consonants were 18 : /k, n, t, m, p, s, c, $C^{h},\;k^{h},\;t^{h},\;p^{h}$, h, I, k', t', p', s', c'/. Fundermental frequency (Fx), Jitter, shimmer, HNR, MPT were measured with by electroglottography using Lx speech studio (Laryngograph Ltd, London, UK). 36 meaningless words produced by esophageal speakers were presented to 3 speech-language pathologists who phonetically transcribed their responses. Fx, Jitter, HNR parameters is significant different between skilled esophageal speakers and unskilled esophageal speakers (P<.05). Considering manner of articulation, ANOVA showed that differences in two esophageal speech groups on speech proficiency were significant; Glide had the highest number of confusion with the other phoneme class, affricates are the most intelligible in the unskilled esophageal speech group, whereas in the skilled esophageal speech group fricatives resulted highest number of confusions, nasals are the most intelligible. In the place of articulation, glottal /h/ is the highest confusion consonant in both groups. Bilabials are the most intelligible in the skilled esophageal speech, velars are the most intelligible in the unskilled esophageal speech. In the structure of syllable, 'CV+V' is more confusion in the skilled esophageal group, unskilled esophageal speech group has similar confusion in both structures. In unskilled esophageal speech, significantly different Fx, Jitter, HNR acoustic parameters of vowel and the highest confusions of Liquid, Nasals consonants could be attributed to unstable, improper contact of neoglottis as vibratory source and insufficiency in the phonatory air supply, and higher motoric demand of remaining articulation due to morphological characteristics of vocal tract after laryngectomy.

• Korean Journal of Bronchoesophagology
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• v.3 no.2
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• pp.302-306
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• 1997

Persistent pharygoesophageal spasm has been demonstrated to be responsible for poor speech rehabilitation after laryngectomy Management of these patients has included bougienage and pharyngeal neurectomy. Achalasia is a disorder of swallowing in which the lower esophageal sphincter fails to relax. Botulinum toxin injection of the upper esophageal sphincter or lower esophageal sphincter has been successfully used diagnostically and therapeutically for esophageal speech failure or achalasia. So, we report the use of botulinum toxin, a paralytic agent, for the treatment of these conditions.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.5-10
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• 1998

Voice rehabilitation is very important concerning in laryngectomees. Esophageal speech is a common and widely used method of voice restoration. But, until now there is no reliable data which shows the aerodynamic characteristics of esophageal speech. In order to evaluate the vocal quality of normal laryngeal and esophageal speech, several aerodynamic parameters were measured in 13 adults with normal laryngeal voice and 2 excellent esophageal speakers using Aerophone II voice function analyzer. The examined parameters were maximal flow rate, mean airflow rate, subglottic pressure, vocal efficiency, glottic resistance, maximal phonation time and mean sound pressure level. In vocal efficiency, there is no difference between two groups, but in other parameters, marked differences were showed in esophageal speakers, especially mean resistance. Results indicates that esophageal speakers make the efficient voices with poor aerodynamic condition, comparing with normal laryngeal speakers.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.2
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• pp.155-163
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• 2002

Background and Objectives : Esophageal voice, Silicone voice Prosthesis with tracheo-esophageal (T-E) puncture have been used as vocal rehabilitation methods for postlaryngectomy. However, long-term follow-up in the voice rehabilitation in the total laryngectomees has not been reported. The purpose of this study is to analyze practice of postlaryngectomy voice rehabilitation and to find the effective voice rehabilitation. Materials and Methods : From Jan 1992 until June 2002, 75 patients underwent a total laryngectomy at Yongdong Severance Hospital. We retrospectively studied voice rehabilitation methods commonly used, acquisition levels of esophageal speech, patients satisfaction scale (5 rating scale) according to the methods in 33 of them (40 died, 2 unavailable) by using charts review, telephone interview. Results : T-E speech is most commonly used by 14 patients (42.4%) : A tracheo-esophageal procedure (primary or secondary puncture) by 21 : and 8 patients removed Provox. 1 patient had no voice rehabilitation. 7 patients (21.2%) have used esophageal speech : 4 patients of them have used it after removing Provox. Electrolarynx has been used with other voice rehabilitation methods : 4 patients have only used this method and 3 patients with T-E speech, 1 patient with esophageal speech. However, 6 patients (18%) remained without a substitute voice rehabilitation. In the satisfaction with speech and management of voice rehabilitation methods, patients using esophageal speech were most satisfied (4.1), patients with T-E speech were unsatisfied (2.3). Regarding with the acquisition level of esophageal speech in 33 patients, 22 patients (66.6%) failed without functional speech. Conclusion : To increase patients satisfaction and to achieve successful voice rehabilitation after total laryngectomy, preoperative counseling, pretesting, appropriate patient selection of each method and team decision-making and postoperative voice therapy must be considered.

• Phonetics and Speech Sciences
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• v.6 no.2
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• pp.115-121
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• 2014

This paper investigates the relationship between acoustic characteristics and voice handicap index for 29 males with esophageal speakers. Acoustic characteristics were measured by using a sustained vowel /a/ three times. The stable vocalization for 2 seconds was analyzed by MDVP program. Specifically, relationships between four VHI scores (total, functional, physical, and emotional) and three acoustic characteristics (jitter, shimmer, and NHR) were investigated using the Pearson correlation coefficient. As results, we found no relationship between NHR and VHI scores. However, both jitter and shimmer had statistically significant correlations with all four VHI scores. This research will contribute to establishing a baseline related to speech characteristics in voice rehabilitation with esophageal speakers. Further research could be done to examine the overall quality of life survey, which is widely used as a subjective measure about voice for patients with esophageal speakers.

• Phonetics and Speech Sciences
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• v.6 no.2
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• pp.47-54
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• 2014

The purpose of this study was to analyze spectral versus cepstral measurements in esophageal speakers. The comparison between the measurements in thirteen male esophageal speakers was compared with the control group of thirteen normal speakers using the sustained vowel /a/. The main results can be summarized as below: (a) the CPP and L/H ratio of the esophageal group were significantly lower than those of the control group (b) the CPP was significantly correlated with the spectral parameters such as jitter, shimmer, NHR and VTI, and (c) the ROC analysis showed that the threshold of 10.25dB for the CPP achieved a good classification for esophageal speakers, with 100% perfect sensitivity and specificity. Thus, it was known that cepstral-based acoustic measures such as CPP, may be more reliable predictors than other spectral-based acoustic measures such as jitter and shimmer. And it was found that cepstral-based acoustic measures were effective in distinguishing esophageal voice quality from normal voice quality. This research will contribute to establishing a baseline related to speech characteristics in voice rehabilitation with laryngectomees.

• Speech Sciences
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• v.5 no.1
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• pp.121-139
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• 1999

Our experimental subject was a laryngectomee who had undergone total laryngectomy with $PROVOX^{(R)}$ insertion, and learned esophageal speech after the surgery, so he could produce both $PROVOX^{(R)}$ voice and esophageal voice. With this subject's production of $PROVOX^{(R)}$ and esophageal voice, we are to compare the acoustic and aerodynamic characteristics of the two voices, under the same physical conditions of the same person. As a result, the fundamental frequency of esophageal voice was 137.2 Hz, and that of $PROVOX^{(R)}$ was 97.5 Hz. $PROVOX^{(R)}$ voice showed lower jitter, shimmer and NHR than esophageal voice, which means that $PROVOX^{(R)}$ voice showed better voice quality than esophageal voice. In spectrographic analysis, the formation of formants and pseudoformants were more distinct in esophageal voice and several temporal aspects of acoutic features such as VOT and closure duration were more similar with normal voice in $PROVOX^{(R)}$ voice. During the sentence utterance, esophageal voice showed longer pause or silence duration than $PROVOX^{(R)}$ voice. Maximum phonation time and mean flow rate of $PROVOX^{(R)}$ voice were much longer and larger than esophageal voice, but mean and range of sound pressure level, subglottic pressure and voice efficiency were similar in the two voices. Glottal resistance of esophageal voice was much larger than $PROVOX^{(R)}$ voice which showed still larger glottal resistance than normal voice.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.2
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• pp.142-146
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• 1998

Background : It has been established that the fundamental frequency(Fo) of the vowels varies systemically as a function of vowel height. Specifically, high vowels have a higher Fo than low vowels. Two major explanations or hypotheses dominate contemporary accounts of fired to explain the mechanisms underlying intrinsic variation in vowel Fo, source-tract coupling hypothesis and tongue-pull hypothesis. Objectives : Total laryngectomy surgery necessiates removal of all structures between the hyoid bone and the tracheal rings. Therefore, the assumption that no direct interconnection exists between the tongue and pharyngoesophageal segment that would mediate systematic variation in vowel Fo appears quite reasonable. If tongue-pull hypothesis is correct, systemic differences in Fo between high versus low vowels produced by esophageal speakers would not Or expected. We analyzed the Fo in the vowels of esophageal voice. Materials and method : The subjects were 11 cases of laryngectomee patients with fluent esophageal voice. The five essential vowels were recorded and analyzed with computer speech analysis system(Computerized Speech Lab). The Fo was measured using acoustic waveform, automatically and manually, and narrow band spectral analysis. Results : The results of this study reveal that intrinsic variation in vowel Fo is clearly evident in esophageal speech. By analysis using acoustic waveform automatically, the signals were too irregular to measure the Fo precisely. So the data from automatic analysis of acoustic waveform is not logical. But the Fo by measuring with manually calculated acoustic waveform or narrowband spectral analysis resulted in acceptable results. These results were interpreted to support neither the source-tract coupling nor the tongue-pull hypotheses and led us to offer an alternative explanation to account for intrinsic variation of Fo.

• The Journal of the Acoustical Society of Korea
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• v.26 no.5
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• pp.182-187
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• 2007

The present study was to investigate the speech intelligibility of esophageal speech, which is the way that the laryngectomized people who lost their voices by total laryngectomy can phonate by using the airstream driven into esophagus, not trachea. Three normal listeners transcribed the CVVand VCV syllables produced by 10 esophageal speakers. As a result, overall intelligibility of esophageal speech was 27%. Affricates showed the highest intelligibility, and fricatives, the lowest. In the aspect of the place of articulation, palatals were the most intelligble, and alveolars, the least. Most of the aspirated consonants showed a low intelligibility. The consonants in VCV syllables were more intelligible than the ones in CVV syllables. The low intelligibility of esophageal speakers is due to insufficient airflow intake into esophagus. Therefore, training to increase airflow intake, as well as correct articulation training, will improve their low intelligibility.