The Effects of Contextual Priming and Alaryngeal Speech Mode on Auditory-Perceptual Ratings of Listener Comfort.

BACKGROUND: The effectiveness of postlaryngectomy communication methods (esophageal, tracheoesophageal, and electrolaryngeal speech) has been primarily evaluated using functional outcomes. This evaluation neglects the importance of listeners and their influence on communicative effectiveness. Listener comfort (LC), or the ease with which a listener interacts with alaryngeal speakers, may provide an important index of communicative effectiveness. The present study investigated the use of LC in the auditory-perceptual evaluation of alaryngeal speech modes, as well as evaluating the influence of contextual cues used to elicit ratings on listener judgments of all three alaryngeal modes. METHODS: Thirty-three naïve listeners provided independent ratings of LC for 39 alaryngeal speech samples using a visual analogue scaling procedure. Each group of listeners rated alaryngeal speech in three imagined listening conditions (Telephone Conversation, Social Situation, and a non-specified Control Condition). To analyze LC ratings obtained, a 3 × 3 mixed factor analysis of variance was conducted. RESULTS: A significant interaction effect between alaryngeal speech mode and listening condition (P = 0.04) was identified. Overall, pairwise comparisons of alaryngeal speech mode indicated that listeners were more comfortable when presented with tracheoesophageal speech samples compared to those of esophageal and electrolaryn geal speakers. CONCLUSIONS: Our data suggest that LC ratings are influenced by alaryngeal speech mode. Tracheoesophagea speech was perceived to have the most favorable LC ratings compared to the other alaryngeal speech modes in all listening conditions. Contextual cues (i.e., social condition and telephone condition) did not have an effect on LC ratings.

Characteristics of velopharyngeal dysfunction in 22q11.2 deletion syndrome: a retrospective case-control study.

OBJECTIVE: To identify and describe the dynamic features of velopharyngeal dysfunction (VPD) in patients with 22q11.2 deletion syndrome relative to patients with non-syndromic cleft palates. STUDY DESIGN: Retrospective case-control study. SETTING: Pediatric tertiary care center. SUBJECTS AND METHODS: A total of 30 children (aged 9-16 years) with VPD were included in this study. Fifteen children with a definitive diagnosis of 22q11.2 deletion syndrome requiring surgical VPD repair were included in the 22q11.2 deletion syndrome group. Fifteen age- and sex-matched children with non-syndromic cleft palate requiring surgical VPD repair were included in the non-syndromic cleft palate group for comparison. Velar displacement, lateral pharyngeal wall displacement, and lateral pharyngeal wall motion pattern data were extracted from preoperative Multiview Videofluoroscopy imaging studies of all children and compared across groups. RESULTS: Lateral pharyngeal wall displacement was found to be reduced in the 22q11.2 deletion syndrome group (U = 29.50, p = .001, r = .63). However, measures of velar displacement were not observed to differ between groups. Similarly, lateral pharyngeal wall motion pattern distributions were not found to differ across these two groups. CONCLUSIONS: Velopharyngeal dysfunction in patients with 22q11.2 deletion syndrome showed differences in dynamic velopharyngeal function when compared to non-syndromic cleft palate patients. The current findings provide initial insights into the unique aspects of velopharyngeal dysfunction for patients with 22q11.2 deletion syndrome. These findings may guide further efforts directed toward understanding the dynamic velopharyngeal characteristics of this population and potentially optimize surgical management and functional outcomes.

Intelligibility of stop-plosive and fricative consonants produced by tracheoesophageal speakers in quiet and noise.

Despite functional levels of postlaryngectomy communication, individuals who undergo total laryngectomy and tracheoesophageal (TE) puncture voice restoration continue to experience significant communication difficulties in noisy environments. In order to identify and further characterize TE speakers' intelligibility in noise, the current auditory-perceptual study investigated stop-plosive and fricative intelligibility of TE speech in quiet and in the presence of multi-talker noise. Eighteen listeners evaluated monosyllabic consonant-vowel-consonant (CVC) words produced by 14 TE speakers using an open-response paradigm. The findings indicate that overall speaker intelligibility was significantly lower in noise. However, further examination of these data revealed a differential effect of noise on intelligibility according to manner and phoneme position. While overall error patterns remained consistent across conditions, the voicing distinction was affected differentially by manner class and articulatory position. The present investigation provides valuable insights into the influence of non-normal and degraded voice signals and differential perceptual patterns when comparing TE speech intelligibility in quiet and noise.

Role of voice rest following laser resection of vocal fold lesions: A randomized controlled trial.

OBJECTIVES/HYPOTHESIS: Voice rest is often prescribed following phonosurgery by most surgeons despite limited empiric evidence to support its practice. This study assessed the effect of postphonosurgery voice rest on vocal outcomes. STUDY DESIGN: Prospective, randomized controlled trial. METHODS: Patients with unilateral vocal fold lesions undergoing CO2 laser excision were recruited in a prospective manner and randomized into one of two groups: 1) an experimental arm consisting of 7 days of absolute voice rest, or 2) a control arm consisting of no voice rest. The primary outcome measure was the Voice Handicap Index-10 (VHI-10) questionnaire. Secondary outcomes included aerodynamic measurements (maximum phonation time), acoustic measures (fundamental frequency, jitter, shimmer, and harmonic-to-noise ratio), and auditory-perceptual measures. Primary and secondary outcomes were assessed preoperatively and reassessed postoperatively at the 1- and 3-month follow-up. Patient compliance to voice rest instructions were controlled for using subjective and objective parameters. RESULTS: Thirty patients were enrolled with 15 randomized to each arm of the study. Statistical analysis for the entire cohort showed a significant improvement in the mean preoperative VHI-10 compared to postoperative assessments at 1-month (19.0 vs. 7.3, P < .05) and 3-month (19.0 vs. 6.2, P < .05) follow-up. However, between-group comparisons showed no significant difference in postoperative VHI-10 at either time point. Similarly, secondary outcome measures yielded no significant difference in between-group comparisons. CONCLUSIONS: Our study shows no significant benefit to voice rest on postoperative voice outcomes as determined by patient self-perception, acoustic variables, and auditory-perceptual analysis. LEVEL OF EVIDENCE: 1b CLINICAL TRIAL NUMBER: NCT02788435 (clinicaltrials.gov) Laryngoscope, 130:1750-1755, 2020.