Effect of singing training on total laryngectomees wearing a tracheoesophageal voice prosthesis

PURPOSE: To assess the effect of a program of singing training on the voice of total laryngectomees wearing tracheoesophageal voice prosthesis, considering the quality of alaryngeal phonation, vocal extension and the musical elements of tunning and legato. METHODS: Five laryngectomees wearing tracheoesophageal voice prosthesis completed the singing training program over a period of three months, with exploration of the strengthening of the respiratory muscles and vocalization and with evaluation of perceptive-auditory and singing voice being performed before and after 12 sessions of singing therapy. RESULTS: After the program of singing voice training, the quality of tracheoesophageal voice showed improvement or the persistence of the general degree of dysphonia for the emitted vowels and for the parameters of roughness and breathiness. For the vowel "a", the pitch was displaced to grave in two participants and to acute in one, and remained adequate in the others. A similar situation was observed also for the vowel "i". After the singing program, all participants presented tunning and most of them showed a greater presence of legato. The vocal extension improved in all participants. CONCLUSION: Singing training seems to have a favorable effect on the quality of tracheoesophageal phonation and on singing voice.(AU)

Correlation of intraluminal esophageal pressure with the dynamic extension of tracheoesophageal voice in total laryngectomees

PURPOSE: To evaluate and correlate the amplitude of esophageal contractions triggered by swallowing water with dynamic extension and habitual, strong and weak sound intensity in total laryngectomees wearing a tracheoesophageal prosthesis. METHODS: Thirty total laryngectomees using tracheoesophageal voice with a phonatory prosthesis were evaluated by measuring the amplitude of contractions in the proximal, middle and distal esophagus and the pressure of the pharyngoesophageal transition by manometry. In order to measure vocal intensity the subject was asked to emit phonation of the vowel /a/ at habitual, strong and weak intensity which was captured with a sound pressure meter. Dynamic extension was calculated by subtracting strong intensity from weak intensity. RESULTS: A positive correlation was observed between contraction amplitude and dynamic extension in the proximal (rho: 0.45; p=0.01) and distal (rho: 0.41; p=0.02) esophagus There was no correlation with other parameters.. Total laryngectomees wearing a phonatory prosthesis with a dynamic extension above 21 dBNPS had greater contraction amplitude than laryngectomees with a dynamic extension below this value. CONCLUSIONS: There was a positive correlation between pressure amplitude in the proximal and distal esophagus and increased dynamic extension. The individuals with normal dynamic extension had greater contraction amplitude in the proximal esophagus than individuals with dynamic extension lower than the expected values for age.(AU)