Speech Intelligibility and Communication-related Quality of Life in Tracheoesophageal Speakers

Abstract

Introduction: Communication plays a dynamic role in human life in developing a relationship with others. Laryngectomy can limit the effectiveness in communication and in turn result in limitation of activities and active participation in social life. Of the three methods for voice restoration after total laryngectomy followed today, tracheoesophageal (TE) speech which is a surgical voice restoration (SVR) method has become the standard of care. Literature review reveals that there are conflicting results regarding the quality of speech produced using TE speech. Materials and methods: The present investigation was designed to explore the speech intelligibility and communication-related quality of life (QOL) in TE speakers and also to examine correlations between speech intelligibility scores and QOL in tracheoesophageal puncture (TEP) speakers. Results: Speech intelligibility ratings of our patients revealed that on average the rating score was 2.13 which places them into the category— “connected speech could be understood with little effort”. Speech (word) intelligibility score revealed a mean of 94.73%. There was a positive correlation between speech (word) intelligibility score, and scores obtained on the speech intelligibility rating scale. Scores obtained on Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) by our patients fall between the scores for well-adjusted and poorly adjusted according to original SECEL data. There was no positive correlation between speech intelligibility (word) scores or the speech intelligibility rating scale scores with SECEL. Discussion/conclusion: Our study revealed that TE speech by SVR helps the patients in producing speech with sufficient intelligibility to communicate well with their family and friends but more challenging with strangers. The fact that no correlation was found between SECEL scores with the speech intelligibility measurements points toward the fact that speech intelligibility measures are assessed under quiet conditions and do not consider the effect of background noise in communication situations encountered in everyday environments. In addition, it reflects that even though good communication skills are important for socialization with the community around them, other factors like the self-esteem and person’s personality, family, education, wealth, religious beliefs, and the environment may also contribute to the overall QOL and hence it is essential that these psychosocial aspects are also addressed during rehabilitation. International Journal of Phonosurgery & Laryngology (2020):