title: Analysis of failure of voice production by a sound-producing voice prosthesis.
abstract: OBJECTIVE
  To analyse the cause of failing voice production by a sound-producing voice prosthesis (SPVP).
  
  
  METHODS
  The functioning of a prototype SPVP is described in a female laryngectomee before and after its sound-producing mechanism was impeded by tracheal phlegm. This assessment included: perceptual voice evaluation of read-aloud prose by an expert listener; inspection of the malfunctioning SPVP; and aero-acoustical in vivo registrations using a computer-based data acquisition system.
  
  
  RESULTS
  Sound-producing voice prosthesis speech is higher pitched, stronger, contains less aperiodic noise and requires a lower airflow rate than the patient's regular tracheoesophageal (TE) shunt speech. Tracheal phlegm caused malfunction of the vibrating silicone lip of the SPVP by causing it to stick to its stainless steel container in an opened position, thereby reducing the SPVP to no more than a regular TE shunt valve from a functional point of view. Tracheal phonatory pressure and dynamic vocal intensity range were not affected by the functional status of the SPVP.
  
  
  CONCLUSIONS
  To exploit the advantages an SPVP could offer female laryngectomees with an atonic or severely hypotonic pharyngoesophageal segment, the sound-producing mechanism of the SPVP needs to be less vulnerable to tracheal phlegm.
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Vrije Universiteit Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: van der Torn
authors.forename: C D L
authors.initials: CD
authors.lastname: van Gogh
authors.forename: I M
authors.initials: IM
authors.lastname: Verdonck-de Leeuw
authors.forename: J M
authors.initials: JM
authors.lastname: Festen
authors.forename: H F
authors.initials: HF
authors.lastname: Mahieu
mesh_terms: D000369:Aged, 80 and over; D001826:Body Fluids; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy; D007831:Larynx, Artificial; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012815:Signal Processing, Computer-Assisted; D013068:Speech Production Measurement / Q000379:methods; D013071:Speech, Alaryngeal; D014132:Trachea