title: Proof of Concept of a Tracheoesophageal Voice Prosthesis Insufflator for Speech Production After Total Laryngectomy.
abstract: OBJECTIVE
  There may have a variety of reasons why patients are unable to produce tracheoesophageal speech after total laryngectomy (TL) including poor pulmonary reserve or other comorbidities that prevent adequate stoma occlusion and intratracheal pressure to voice. Other patients find it difficult, uncomfortable, or socially awkward to manually occlude the stoma with the finger or thumb.
  
  
  OBJECTIVE
  The study aimed to assess the feasibility of achieving TE speech with a prototype TE voice prosthesis insufflator (TEVPI).
  
  
  METHODS
  We prospectively assessed the feasibility of achieving TE speech with a commercially available continuous positive airway pressure device in six TL patients.
  
  
  METHODS
  The intervention is the use of a prototype TEVPI.
  
  
  METHODS
  A battery of acoustic and perceptual metrics were obtained and compared between TEVPI speech and standard tracheoesophageal voice prosthesis (TEVP) speech.
  
  
  RESULTS
  Voicing was accomplished with the TEVPI in five of six participants. On average, the duration of phonation with TEVPI was shorter, not as loud, and perceived to be more difficult to produce compared to TEVP speech.
  
  
  CONCLUSIONS
  The TEVPI is a feasible, hands-free solution for restoring speech after TL. Although the current model produced inferior acoustic metrics compared with standard TEVP speech, further modification and refinement of the device has the potential to produce much improved speech.
authors.affiliation: Division of Speech Language Pathology, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Heather
authors.initials: H
authors.lastname: Starmer
authors.affiliation: Department of Computer Science, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Russell H
authors.initials: RH
authors.lastname: Taylor
authors.affiliation: Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Salem I
authors.initials: SI
authors.lastname: Noureldine
authors.affiliation: Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: Jeremy_richmon@meei.harvard.edu.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Richmon
mesh_terms: D000368:Aged; D006801:Humans; D007825:Laryngectomy; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D000075082:Proof of Concept Study; D011446:Prospective Studies
keywords: Aphonia; Speech rehabilitation; Total laryngectomy; Tracheoesophageal prosthesis; Tracheoesophageal speech