A membrane-based voice-producing element for female laryngectomized patients

J.W. Tack, H.A.M. Marres, C.A. Meeuwis, E.B. van der Houwen, G. Rakhorst, G.J. Verkerke

Research output: Chapter in Book/Report/Conference proceedingConference contributionAcademicpeer-review


Despite state of the art tracheo-esophageal (TE) voice-rehabilitation after laryngectomy, some patients are unable to produce voice of sufficient quality, because of hypotonicity or atonicity of their pharyngo-esophageal (PE) segment. Furthermore, the TE voice is low pitched, which presents a problem especially for female laryngectomized patients. A voice-producing element (VPE) is developed, based on the double-membrane concept, to supply the laryngectomized patients with a better substitute voice. The VPE is comprised of two elastic membranes inside a circular housing that can be inserted in a shunt valve. Four identical prototypes were manufactured and tested in-vitro under physiological conditions. Prototypes were also tested in 17 female laryngectomised patients. An aerodynamic and acoustical analysis was performed, the maximum phonation time, speech rate and intonation capability determined. Finally the voice was perceptual evaluated. Basic sound, containing multiple harmonics, was successfully produced under physiologic air pressure and airflow conditions. The fundamental frequency and sound pressure level could be controlled by changing the driving pressure, thus enabling sufficient intonation. The obtained frequency range (190 - 350 Hz) is appropriate for producing a female voice. The VPE produced a sound with a low noise-toharmonics ratio (mean 0.15), the efficiency of sound production (5.5•10-5) is comparable to normal vocal folds. The clinical study clearly showed that the pitch and sound intensity were increased without an unacceptable increase in driving lung pressure. The flow rates were lower than normal, leading to significantly longer phonation times. Accumulation of mucus did not interfere with speech production. Functional restoration of the voice after laryngectomy with a VPE, based on the double-membrane concept, appears a feasible concept for female laryngectomized patients or patients with a hypo- or atonic PE segment.

Original languageEnglish
Title of host publication4th European Conference of the International Federation for Medical and Biological Engineering
Subtitle of host publicationECIFMBE 2008 23–27 November 2008 Antwerp, Belgium
EditorsJos Vander Sloten, Pascal Verdonck, Marc Nyssen, Jens Haueisen
Number of pages4
ISBN (Electronic)978-3-540-89208-3
ISBN (Print)978-3-540-89207-6
Publication statusPublished - 1 Dec 2008
Externally publishedYes
Event4th European Conference of the International Federation for Medical and Biological Engineering, ECIFMBE 2008 - Antwerp, Belgium
Duration: 23 Nov 200827 Nov 2008
Conference number: 4

Publication series

NameIFMBE Proceedings
ISSN (Print)1680-0737


Conference4th European Conference of the International Federation for Medical and Biological Engineering, ECIFMBE 2008
Abbreviated titleECIFMBE 2008


  • Aero-acoustics
  • Artificial organ
  • Laryngectomy
  • Shunt valve
  • Voice rehabilitation
  • Voice-producing prosthesis


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