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Alaryngeal Speech Aerodynamics: Lower and Upper Airway Considerations

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Clinical Care and Rehabilitation in Head and Neck Cancer

Abstract

Separation of the upper and lower airway in total laryngectomy alters the functioning of the lungs. Tissue inflammation, altered ciliary function, and altered lung volumes and capacities in standard pulmonary function tests are common. Additionally, filtering, humidifying, and warming of inhaled air are compromised. These surgical outcomes on respiration are further complicated by the fact that many people with a laryngectomy are former (and some current) smokers with underlying respiratory disease such as chronic obstructive pulmonary disease. Dissociation between breathing and speaking has been reported across alaryngeal speaking methods with a certain percentage of people speaking during inspiration. Elevated lung volume levels at initiation of speaking and increased resting expiratory levels are noted in tracheoesophageal speakers. Increased pressure is required to initiate neoglottal vibration in esophageal and tracheoesophageal speech, and air flow through the voice source is reduced, resulting in elevated voice source resistance compared to those with a larynx. The tracheoesophageal voice prosthesis also adds to the aerodynamic resistance in this method of communication. Finally, oral air pressure during consonant production is increased for all three methods of alaryngeal communication. Overall, there are substantial changes to breathing in people with a laryngectomy. Voice production in esophageal, tracheoesophageal, and pneumatic artificial larynx speech is powered aerodynamically and therefore can be impacted by a person’s respiratory status and other factors (e.g., valve characteristics, neoglottal properties, etc.). Articulatory aerodynamics have not been widely studied other than oral air pressure which is elevated in nearly all alaryngeal speakers.

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  1. Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA

    Jeff Searl

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  1. Department of Otolaryngology Head and Neck Surgery and School of Communication Sciences & Disorders , Western University, London, ON, Canada

    Philip C. Doyle

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Searl, J. (2019). Alaryngeal Speech Aerodynamics: Lower and Upper Airway Considerations. In: Doyle, P. (eds) Clinical Care and Rehabilitation in Head and Neck Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-04702-3_13

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