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Figure 1.1: Drawing of voice rehabilitation following total laryngectomy using a electrolarynx.

Electromechanical Speech

Within this group, there are transcervical and intraoral devices. Both rely on the principle of introducing an electromechanical vibration that can be heard as a tone. The transcervical device (e.g. Servox) is placed against

issue of the neck that will transmit the tone to the oral cavity (figure 1.1). The remaining intact structures of the vocal tract (tongue, lips and teeth) will modulate the tone. This articulation will than produce speech. Devices like the Servox are rechargeable and have volume and pitch control (figure 1.2).

The intraoral device (e.g. Cooper-Rand) introduces the sound source through a tube directly into the oral cavity. Voice generation occurs in the same way as with the transcervical devices.

The major advantage of both devices is that basic speech is learned quickly by most patients and does not interfere or delay the mastering of other forms of alaryngeal speech. Furthermore, this form of voice rehabilitation produces a loud voice. However, certain patient conditions prevent the use of these devices. Severe surgery and radiation therapy induces fibrosis of the neck hampering the transmitting of the tone towards the oral cavity. Limited dexterity also determines the successful use of an electrolarynx.though these devices are quite expensive, this voice rehabilitation technique is still considered to be one of the cheaper options.

The major disadvantages of these electromechanical devices is the distinct voice quality. The voice production sounds mechanical and even robot like, distracting the listeners attention. The electrolarynx requires the use of a hand and has a conspicuous appearance.

Electromechanical devices can be a useful treatment option in the early post-operative phase when the patient can not use other voice rehabilitation techniques, thereby limiting the frustration of speechlessness. Electrolarynx devices can also be of value in addition to other voice rehabilitation methods

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Copyright 1998 Medical Illustrations
Last modified: January 07, 1999

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