A voice-producing Prosthesis for laryngectomized patients

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

doi:10.1109/ICICI-BME.2009.5417222

A voice-producing Prosthesis for 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 proceeding › Conference contribution › Academic › peer-review

Abstract

Despite state of the art tracheo-esophageal (TE) voice-rehabilitation after laryn-gectomy, 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 laryn-gectomised 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-to-harmonics 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. In conclusion, 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 language	English
Title of host publication	International Conference on Instrumentation, Communication, Information Technology, and Biomedical Engineering 2009, ICICI-BME 2009
Place of Publication	Piscataway, NJ
Publisher	IEEE
ISBN (Electronic)	978-1-4244-5000-8 (CD)
ISBN (Print)	978-1-4244-4999-6
DOIs	https://doi.org/10.1109/ICICI-BME.2009.5417222
Publication status	Published - 1 Dec 2009
Externally published	Yes
Event	International Conference on Instrumentation, Communication, Information Technology, and Biomedical Engineering 2009, ICICI-BME 2009 - Bandung, Indonesia Duration: 23 Nov 2009 → 25 Nov 2009

Conference

Conference	International Conference on Instrumentation, Communication, Information Technology, and Biomedical Engineering 2009, ICICI-BME 2009
Abbreviated title	ICICI-BME 2020
Country/Territory	Indonesia
City	Bandung
Period	23/11/09 → 25/11/09

Keywords

Aero-acoustics
Artificial organ
Laryngectomy
Shunt valve
Voice rehabilitation

Access to Document

10.1109/ICICI-BME.2009.5417222

Cite this

Tack, J. W., Marres, H. A. M., Meeuwis, C. A., van der Houwen, E. B., Rakhorst, G., & Verkerke, G. J. (2009). A voice-producing Prosthesis for laryngectomized patients. In International Conference on Instrumentation, Communication, Information Technology, and Biomedical Engineering 2009, ICICI-BME 2009 Article 5417222 IEEE. https://doi.org/10.1109/ICICI-BME.2009.5417222

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title = "A voice-producing Prosthesis for laryngectomized patients",

abstract = "Despite state of the art tracheo-esophageal (TE) voice-rehabilitation after laryn-gectomy, 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 laryn-gectomised 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-to-harmonics 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. In conclusion, 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.",

keywords = "Aero-acoustics, Artificial organ, Laryngectomy, Shunt valve, Voice rehabilitation",

author = "J.W. Tack and H.A.M. Marres and C.A. Meeuwis and {van der Houwen}, E.B. and G. Rakhorst and G.J. Verkerke",

year = "2009",

month = dec,

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doi = "10.1109/ICICI-BME.2009.5417222",

language = "English",

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booktitle = "International Conference on Instrumentation, Communication, Information Technology, and Biomedical Engineering 2009, ICICI-BME 2009",

publisher = "IEEE",

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note = "International Conference on Instrumentation, Communication, Information Technology, and Biomedical Engineering 2009, ICICI-BME 2009, ICICI-BME 2020 ; Conference date: 23-11-2009 Through 25-11-2009",

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Tack, JW, Marres, HAM, Meeuwis, CA, van der Houwen, EB, Rakhorst, G & Verkerke, GJ 2009, A voice-producing Prosthesis for laryngectomized patients. in International Conference on Instrumentation, Communication, Information Technology, and Biomedical Engineering 2009, ICICI-BME 2009., 5417222, IEEE, Piscataway, NJ, International Conference on Instrumentation, Communication, Information Technology, and Biomedical Engineering 2009, ICICI-BME 2009, Bandung, Indonesia, 23/11/09. https://doi.org/10.1109/ICICI-BME.2009.5417222

A voice-producing Prosthesis for laryngectomized patients. / Tack, J.W.; Marres, H.A.M.; Meeuwis, C.A. et al.
International Conference on Instrumentation, Communication, Information Technology, and Biomedical Engineering 2009, ICICI-BME 2009. Piscataway, NJ: IEEE, 2009. 5417222.

Research output: Chapter in Book/Report/Conference proceeding › Conference contribution › Academic › peer-review

TY - GEN

T1 - A voice-producing Prosthesis for laryngectomized patients

AU - Tack, J.W.

AU - Marres, H.A.M.

AU - Meeuwis, C.A.

AU - van der Houwen, E.B.

AU - Rakhorst, G.

AU - Verkerke, G.J.

PY - 2009/12/1

Y1 - 2009/12/1

N2 - Despite state of the art tracheo-esophageal (TE) voice-rehabilitation after laryn-gectomy, 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 laryn-gectomised 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-to-harmonics 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. In conclusion, 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.

AB - Despite state of the art tracheo-esophageal (TE) voice-rehabilitation after laryn-gectomy, 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 laryn-gectomised 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-to-harmonics 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. In conclusion, 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.

KW - Aero-acoustics

KW - Artificial organ

KW - Laryngectomy

KW - Shunt valve

KW - Voice rehabilitation

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U2 - 10.1109/ICICI-BME.2009.5417222

DO - 10.1109/ICICI-BME.2009.5417222

M3 - Conference contribution

AN - SCOPUS:77950955722

SN - 978-1-4244-4999-6

BT - International Conference on Instrumentation, Communication, Information Technology, and Biomedical Engineering 2009, ICICI-BME 2009

PB - IEEE

CY - Piscataway, NJ

T2 - International Conference on Instrumentation, Communication, Information Technology, and Biomedical Engineering 2009, ICICI-BME 2009

Y2 - 23 November 2009 through 25 November 2009

ER -

A voice-producing Prosthesis for laryngectomized patients

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Keywords

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