• 대한후두음성언어의학회지
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• 제19권1호
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• pp.28-30
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• 2008

The problem of voice restoration after total laryngectomy has existed ever since Billroth's first total laryngectomy in 1873. Since then, all the efforts to restore the voice was tried to divert the tracheal air to the pharynx to produce voice, which became the tracheo-esophageal shunt voice currently used. With the intact pharyngoesophagus, however, there are two basic options for speech rehabilitation : the artificial larynx and esophageal voice. The artificial larynx is an electrically driven buzzer or a sound transducer and its most common type is placed against a supple point on patient's neck and introduces a mechanical sound into the tissues and air spaces of the neck. This sound, emanating form the mouth, is articulated by the intact structures of the remaining vocal tract as understandable speech. Esophageal voice is a commonly recommended method for alaryngeal speech rehabilitation, which can be successfully done by regurgitating the air stored in the esophagus. Successful esophageal voice is preferable to the artificial larynx but, most patients usually adapt only one of those methods according to their needs and feasibility to learn.

• 말소리와 음성과학
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• 제5권4호
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• pp.17-24
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• 2013

This study is aimed at finding out different types of speech characteristics categorized based on voice rehabilitation techniques used on twenty-six patients (all-male) with total or partial laryngectomees. The speech intelligibility of standard esophageal (SE), tracheoesophageal speech (TE), and electriclarynx (EL) was measured by using the CSL and eleven listeners were instructed to rate the speech on a 5-point scale. The vowel space parameters such as vowel space, VAI, FCR, and F2 ratio were measured by averaging 5 repeats of each vowel (/a/, /e/, /i/, /u/) and the results were put into the parameter formula. The results showed significant statistical differences in speech intelligibility and vowel space between SE and TE. The speech intelligibility and vowel space of TE were higher than those of SE or EL and there was a high correlation between speech intelligibility and some parameters (vowel space, VAI, F2 ratio). The results also showed that TE's speech characteristics were most similar to normal groups comparing with SE and EL, but still very deviant in laryngeal speech. This was due to insufficient airflow intake into the esophagus when producing sounds, and because articulation movement was carried out differently among groups. Therefore, these findings will contribute to establishing a baseline related to speech characteristics in voice rehabilitation for patients with alaryngeal speech.

• 대한음성학회:학술대회논문집
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• 대한음성학회 2003년도 10월 학술대회지
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• pp.133-137
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• 2003

The purpose of this study was to provide acoustic data on the voice of the laryngectomized patients for more scientific and efficient voice rehabilitation. The phonation of prolonged /a/ of 9 electronic artificial larynx(AL) users, 5 esophageal(EP) speech users, and 2 tracheo-esophageal(TEP) voice users were recorded and analyzed using Multi-Speech. Habitual f0, mean f0, sd f0, max f0, min f0, jitter, shimmer, and NHR were compared among groups of subjects using t-test. The EP and TEP groups exhibited higher f0 compared to the AL group. The AL and TEP groups showed more stable f0 than the EP group. In addition, the quality of TEP and EP voices were comparatively better in terms of jitter, shimmer, and NHR.

• 대한후두음성언어의학회지
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• 제3권1호
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• pp.6-12
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• 1989

Methods of voice rehabilitation in laryngectomees include training of esophageal speech, use of electrolarynx and pneumatic speech aid and surgical methods, etc. In this paper, we introduce the experimental model of obturator-type electrolarynx which has several advantages for use such as ease of learning, no disagreeable appearance, and both hands not being occupied. We compared it to normal voice and other voice rehabilitation methods such as esophageal voice, japanese pneumatic speech aid and cervical electrolarynx in intelligibility and sonagraphic evaluation. The results are as follows; 1) Obturator-type electrolarynx exhibited the lowest intelligibility. 2) In sonagraphic evaluation, the spectrogram produced by the obturator-type electrolarynx was the most different from those of normal voice.

• 말소리와 음성과학
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• 제5권4호
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• pp.25-32
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• 2013

This research is aimed at finding the acoustic characteristics of different voice rehabilitation techniques, the electrolaryx (EL), standard esophageal (SE), and tracheoesophageal (TE), used on 17 patients with laryngectomees. The analysis of the voice qualities was achieved using MDVP. In order to compare the acoustic characteristics, patients were asked to produce the vowel /a/ sound. The acoustic analysis included fundamental frequency (f0), jitter, shimmer, and noise-to-harmonic ratio (NHR). The main acoustic results showed no significant statistical differences between the average measurements of SE and TE speakers. It was found that the current study showed the same tendency found in previous studies. There was also a significant difference between SE and EL speakers. On the other hand, there were no significant statistical differences between the average measurements of TE and EL speakers on all acoustic measurements. This research will contribute to establishing a baseline related to speech characteristics in voice rehabilitation for patients with laryngectomees. In future, the present findings and issues should be considered in the context of gender. Specifically, the number of women who are diagnosed with laryngeal cancer continues to rise and their acoustic characteristics may indeed differ from those of men.

• 음성과학
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• 제7권1호
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• pp.53-64
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• 2000

Theoretically, alaryngeal speakers have difficulty in accomplishing the production of voiceless consonants. However, the perceptual studies often reveal a clear production of voiceless consonants giving good articulation scores in skilled alaryngeal speakers. The purpose of the present study was to clarify the production of voiceless stops in mode of articulation to normal speakers and skilled alaryngeal speakers. The acoustic characteristics of alaryngeal speech compared to the normal speech were investigated with special reference to the voiceless stop consonants. The surface electromyography from neck is used to monitor pharyngeal activity during speech. The general result is. that esophageal, shunt and neoglottal speakers realize the distinctions between the three types of [p] in a manner parallel to normals, whereas those using an electric voice generator do not.

• Archives of Plastic Surgery
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• 제44권6호
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• pp.550-553
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• 2017

Esophageal perforation is a rare but potentially fatal complication of robot-assisted thyroidectomy (RAT). Herein, we report the long-term outcome of an esophageal reconstruction with a jejunal free flap for esophageal rupture after RAT. A 33-year-old woman developed subcutaneous emphysema and hoarseness on postoperative day1 following RAT. Esophageal rupture was diagnosed by computed tomography and endoscopy, and immediate surgical exploration confirmed esophageal rupture, as well as recurrent laryngeal nerve injury. We performed a jejunal free flap repair of the 8-cm defect in the esophagus. End-to-side microvascular anastomoses were created between the right external carotid artery and the jejunal branches of the superior mesenteric artery, and end-to-end anastomosis was performed between the external jugular vein and the jejunal vein. The right recurrent laryngeal nerve injury was repaired with a 4-cm nerve graft from the right ansa cervicalis. Esophagography at 1 year after surgery confirmed that there were no leaks or structures, endoscopy at 1 year confirmed the resolution of vocal cord paralysis, and there were no residual problems with swallowing or speech at a 5-year follow-up examination. RAT requires experienced surgeons with a thorough knowledge of anatomy, as well as adequate resources to quickly and competently address potentially severe complications such as esophageal rupture.

• 대한후두음성언어의학회지
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• 제27권1호
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• pp.18-20
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• 2016

Total laryngectomy remains as an important treatment option in selected patients with laryngopharyngeal cancers, which inevitably sacrifices naturally produced voice. Much effort has been devoted to voice restoration for these laryngectomized patients. Several ways of voice rehabilitation after total laryngectomy have been developed and utilized thus far, including tracheoesophageal shunt speech, esophageal speech, pneumatic speech aid, and electrolarynx. Of these, tracheoesophageal shunt speech appears to be the most effective voice restoration method, while other trials might also be useful in special situations. Nevertheless, each method has its own unique mechanisms of voice production, thus has its advantages and drawbacks in clinical setting. In this review, we discuss the currently available management options for the rehabilitation of laryngectomized voice.

• 대한후두음성언어의학회지
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• 제15권2호
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• pp.92-97
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• 2004

Background and Objectives : The purpose of this study was to examine objectively pre and post operative voice quality evaluation and intelligibility of alaryngeal voice using speech recognition program, HUVOIS. Materials and Methods : 2 laryngologists and 1 speech pathologist were evaluated 'G', 'R', 'B' in the GRBAS sclae and speech intelligibility using NTID rating scale from standard paragraph. And also acoustic estimates such as jitter, shimmer, HNR were obtained from Lx Speech Studio. Results : Speech recognition rate was not significantly different between pre and post operation for pathological vocie samples though voice quality(G, B) and acoustic values(Jitter, HNR) were significantly improved after post operation. In Alaryngeal voices, reed type electrolarynx 'Moksori' was the highest both speech intelligibility and speech recognition rate, whereas esophageal speech was the lowest. Coefficient correlation of speech intelligibility and speech recognition rate was found in alaryngeal voices, but not in pathological voices. Conclusion : Current study was not proved speech recognition program, HUVOIS during telephone program was not objective and efficient method for assisting subjective GRBAS scale.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 1994년도 제2회 학술대회 연제순서 및 초록집
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• pp.86-86
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• 1994

후두 전적출술 후 음성의 소실은 환자에게 정신적으로 많은 영향을 주기 때문에 음성의 회복은 환자의 재활에 중요한 부분으로 여러 가지 방법 이 고안되었으나 아직 만족할 만한 방법은 없다. 식도발성은 기구나 손을 사용할 필요가 없이 정상인과 같이 자연스럽게 말할 수 있어 가장 이상적인 음성재활 법이나, 습득하는데 오랜 시간과 노력이 필요할 뿐만 아니라 음성의 질이 나쁜 단점이 있다. 또한 현재까지 식도발성의 성공여부를 예측할 수 있는 방법이나 성공 율을 높일 수 있는 수술법 등에 대한 연구는 많았지만 음성재활을 위한 식도발성의 특성이나 언어의 명료도에 대한 연구는 부족하다. (중략)