Klaske van Sluis

10 1.5. Speech rehabilitation after total laryngectomy esophageal speech is visualized. Figure 1.3: Schematic drawing of esophageal speech. Air from the mouth is injected in the esophagus and subsequently expelled, which results in mucosal vibrations of the pharyngo-esophageal segment and generates voice. 1.5.3 Electrolarynx speech Speech rehabilitation with an artificial larynx involves a substitute sound source. This can be a pneumatic device, a pipe leading from the stoma to the mouth housing a rubber membrame which vibrates on pulmonary air stream. Or an electrolarynx is used, a (mostly) handheld device which can be placed against the neck or cheek. This electronic device mechanically generates sound which is transmitted through the tissue, the tissue turning air within the vocal tract into vibration. Speech is generated by articulatory movements. Typically these devices have separate buttons for pitch and loudness manipulations. An ad- vantage of electrolarynx speech is that it can be utilized within the first few days after the laryngectomy surgery, it is low-cost and has a fairly high success rate. Disadvantages are that the sound of the voice is mechanical and perceived as unnatural and that intelligibility is less than tacheoesophageal speech and esophageal speech [21]. In Figure 1.4 electrolarynx speech is visualized. 1.5.4 Functional issues following total laryngectomy To help patients adapt to post-laryngectomy life and to minimize negative con- sequences, multidisciplinary rehabilitation is provided. Apart from the changes