[Mechanism of esophageal speech after total laryngectomy].

OBJECTIVE: To evaluate the characteristics of esophageal speech after total laryngectomy. METHODS: Esophageal speech evaluation of 40 cases of esophageal phonation included acoustic parameters, intraesophageal pressures during phonation, speech intelligibility, fluency, communication, respiratory sound and cognate distinctions between voiced and voiceless sounds. RESULTS: In 8 poor speakers, the neoglottis was spasmodic and difficult to vibrate during phonation. In 32 good speakers, the neoglottis was relaxed and easy to vibrate during phonation. The training age, speech intelligibility, fluency, communication, respiratory sound, cognate distinctions between voiced and voiceless sounds and intraesophageal pressures during phonation were significantly different between good and poor esophageal speakers. Vocal characteristics of good speakers differed significantly from those in the normal (P < 0.05 or P < 0.01). The upper intraesphageal pressure during esophageal phonation was higher than that of the normal, especially for poor esophageal phonation. The middle to lower intraesphageal pressures was highest during poor esophageal phonation. CONCLUSIONS: Esophageal phonation was completely alaryngeal, and its activators also differ completely, so phonation could not maintain much longer. Patients with poor esophageal phonation could not drive the air through the neoglottis freely.