title: Development of a double-membrane sound generator for application in a voice-producing element for laryngectomized patients.
abstract: For voice rehabilitation after total laryngectomy a shunt valve is usually placed in the tracheo-esophageal (TE) wall, thereby enabling the production of a TE voice. Some patients, however, are unable to produce a voice of sufficient quality. Furthermore, the TE voice is low pitched, which presents a problem especially for female laryngectomized patients. The voice quality after laryngectomy might be improved by introducing a voice-producing element (VPE) into the TE shunt valve. In this study a sound generator was developed that is suitable for application in such a VPE. This sound generator consists of two elastic membranes placed parallel inside a circular housing. A substitute voice source is created when the membranes start to vibrate via a constant flow of air passing between them. To determine the optimal membrane configuration for proper functioning under physiological conditions, up-scaled physical VPE models with different membrane geometries were evaluated using in vitro experimental tests. For certain membrane geometries the tests showed that a basic sound, containing multiple harmonics, could be successfully produced under physiological air pressure and airflow conditions. The fundamental frequency (60-95 Hz) and sound pressure level (57-78 dB, at 15 cm microphone distance) were regulated via changes in the driving pressure, thereby enabling the possibility of intonation in laryngectomized patients' speech. The obtained frequency range is considered appropriate for producing a substitute voice source for female patients. The geometry considerations in this study can be used for the development of a true scale VPE that can be evaluated clinically, to eventually replace the voice after laryngectomy.
authors.affiliation: Department of BioMedical Engineering, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
authors.forename: J W
authors.initials: JW
authors.lastname: Tack
authors.forename: G J
authors.initials: GJ
authors.lastname: Verkerke
authors.forename: E B
authors.initials: EB
authors.lastname: van der Houwen
authors.forename: H F
authors.initials: HF
authors.lastname: Mahieu
authors.forename: H K
authors.initials: HK
authors.lastname: Schutte
mesh_terms: D005260:Female; D006801:Humans; D007825:Laryngectomy; D011474:Prosthesis Design / Q000295:instrumentation / Q000379:methods; D013061:Speech Acoustics; D013071:Speech, Alaryngeal / Q000295:instrumentation / Q000379:methods; D014833:Voice Quality