Assessment of tracheoesophageal speech in a tonal language: A prospective study

Abstract

Background: Tracheoesophageal puncture followed by insertion of a voice prosthesis is an increasingly popular method for voice rehabilitation after total laryngectomy. Objectives: To perform a functional assessment of voice produced by means of the Blom-Singer valve in a tonal language (Cantonese). Design: Prospective study. Setting: Hospital referral center. Main Outcome Measure: A 5-point scoring scale was adopted for 15 test items of speech assessment grouped into 4 categories: phonatory skills, articulation, additional factors, and general judgment. The sum of the scores for the 15 items was the final speech score. The final speech score was rated as poor, satisfactory, or excellent if it was in the range of less than 30, 31 to 45, or 46 to 75, respectively. Results: Forty-four users of the Blom-Singer valve who had undergone total laryngectomy and primary tracheoesophageal puncture were available for functional assessment. The final speech score was poor in 2 patients (5%), satisfactory in 4 (9%), and excellent in 38 (86%). Conclusion: Chinese patients can speak satisfactory tonal language with the Blom-Singer voice prosthesis.