Artificial larynx prosthesis: Comparative clinical evaluation

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Abstract
The work pioneered by Drs. Singer and Blom established the clinical feasibility of controlled tracheoesophageal fistula for generation of fluent esophageal speech. There have been numerous practical difficulties that have been encountered with the use of voice prosthesis. Problems encountered are: extrusion, speech initiation delay, leakage around the prosthesis, stoma obstruction, and low volume output. A second generation laryngeal prosthesis is introduced for comparison. Its design incorporates features that will significantly improve the clinical problems encountered; extrusion is minimized; and the new prosthesis allows for one size to fit all patients. A clinical trial was established to directly compare the artificial speech generated by the currently existing laryngeal prosthesis. Each laryngectomy patient was fitted with three different devices and the resulting speech was evaluated. Video recordings of patients are presented to illustrate the type of speech produced by each device. Comparisons of intelligibility, fluency, volume, and patient preference are made. Results indicate that a significant variation in the speech obtained is critically dependent on the choice of prosthesis.

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