Esophageal voice 



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Esophageal Speech

Esophageal speech is based on the technique in which the patient transports a small amount (75 ml) of air into the esophagus. Probably due to an increased thoracic pressure, the air is forced back past the pharyngo-esophageal (PE) segment to induce resonance. This resonance is the sound source that allows speech. Rapid repetition of the aforementioned air transport can produce understandable speech (figure 1.3).

There are various techniques to transport air to the esophagus. With the injection technique the tongue forces air back into the pharynx and esophagus. In the first phase of this technique the tongue forces air in the mouth back into the pharynx. In the second phase the back of the tongue forces the air into the esophagus. The right synchronization of these two phases is of great importance transporting the air into the esophagus. With the inhalation methods of esophageal speech the patient creates a pressure in the esophagus that is lower compared to the atmospheric pressure. Since there is a lower pressure in the esophagus, air will flow through the mouth past the PE-segment into the esophagus. The patient will need to inhale to be able to create a low endo-thoracic and esophageal pressure. The last technique of capturing air is by means of swallowing air into the stomach.

Advantages of esophageal speech are the cost aspect since it does not require expensive devices and prostheses, hands-free speech and a more natural sounding voice compared to electrolarynx assisted speech.

The main disadvantage is its success rate of acquiring useful voice production which is reported to be as low as 25%.30 Furthermore, esophageal speech results in low-pitched (60-80 Hz) and low intensity speech which frequently results in poor intelligibility.31

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Copyright 1998 Medical Illustrations
Last modified: January 07, 1999

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