CORRELATION BETWEEN MAXIMUM PHONATION TIME AND ...
CORRELATION BETWEEN MAXIMUM PHONATION TIME AND VOCAL INTENSITY IN TOTAL LARYNGECTOMEES USING A TRACHEOESOPHAGEAL PROSTHESIS Hilton Ricz, Telma Kioko Takeshita-Monaretti, Roberto Oliveira Dantas, Flávia da Silva Pinto Neves, Lílian Aguiar-Ricz School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
After total laryngectomy, the upper digestive tract starts to be responsible for alaryngeal voice production. The quality of the interaction between the respiratory and digestive tracts seems to influence the results of alaryngeal voice and speech. On this basis, knowledge of vocal parameters such as maximum phonation time and vocal intensity may favor the establishment of normative data and the physiological understanding of tracheoesophageal voice production. Thus, the objective of the present study was to correlate maximum phonation time with usual, maximum and minimum vocal intensity and dynamic extension in total laryngectomees speaking by means of a tracheoesophageal prosthesis.
The study included 36 total laryngectomees (29 men and seven women) with a mean age of 62.2 years. All participants underwent insertion of a Provox® tracheoesophageal prosthesis (Atos Medical AB, Hörby, Sweden) and voice and speech rehabilitation. Voice recordings were obtained in a sound-treated room with noise monitoring below 50 dBNPS, measured with a digital decibel meter. Mean ambient temperature was 24.7°C and mean humidity was 46.9%, monitored with a portable digital thermohygrometer. Vocal intensity (usual, maximum and minimum) was recorded by the emission of the vowel “a” (decibel), using a decibel meter positioned one meter away from the oral cavity. Dynamic extension consisted of the maximum and minimum intensities captured by the decibel meter. The maximum phonation times of the vowels “a”,“i”,“u” were measured (seconds) after deep inspiration using a digital chronometer, with the mean value of the emissions being obtained. Data were analyzed statistically by the Pearson correlation coefficient, with the level of significance set at 5%.
Table 1 - Description of the mean, median, standard deviation (SD), minimum and maximum (Min-Max) of maximum phonation time vocal parameters in seconds (s), vocal intensity (usual, weak and strong) and dynamic extension in decibels (dB) in laryngectomee tracheoesophageal prosthesis users (n) Vocal parameter
n
Mean
Median
SD
Min-Max
Maximum phonation time
36
6,37
5,7
4,4
1,8-26
Usual vocal intensity
36
70,8
72,1
4,8
60,2-79
Maximum vocal intensity
36
77,1
76,1
5,9
65-91,5
Minimum vocal intensity
36
67,3
66,8
5,2
56,5-84
Dynamic Extension
36
11,2
10,2
5,2
2,1-24,5
Table 2 - Correlation between the vocal parameter maximum phonation time (MPT) and vocal intensity (usual, maximum and minimum) and dynamic extension in decibels (dB) in laryngectomee tracheoesophageal prosthesis users (n). Vocal parameter
n
*Coefficient
P value
MPT x Usual vocal intensity
36
0,10
0,53
MPT x Maximum vocal intensity
36
0,33
0,04
MPT x Minimum vocal intensity
36
-0,73
0,67
MPT x Dynamic extension
36
0,53
0,001
*Pearson’s Correlation Coefficient p
After total laryngectomy, the upper digestive tract starts to be responsible for alaryngeal voice production. The quality of the interaction between the respiratory and digestive tracts seems to influence the results of alaryngeal voice and speech. On this basis, knowledge of vocal parameters such as maximum phonation time and vocal intensity may favor the establishment of normative data and the physiological understanding of tracheoesophageal voice production. Thus, the objective of the present study was to correlate maximum phonation time with usual, maximum and minimum vocal intensity and dynamic extension in total laryngectomees speaking by means of a tracheoesophageal prosthesis.
The study included 36 total laryngectomees (29 men and seven women) with a mean age of 62.2 years. All participants underwent insertion of a Provox® tracheoesophageal prosthesis (Atos Medical AB, Hörby, Sweden) and voice and speech rehabilitation. Voice recordings were obtained in a sound-treated room with noise monitoring below 50 dBNPS, measured with a digital decibel meter. Mean ambient temperature was 24.7°C and mean humidity was 46.9%, monitored with a portable digital thermohygrometer. Vocal intensity (usual, maximum and minimum) was recorded by the emission of the vowel “a” (decibel), using a decibel meter positioned one meter away from the oral cavity. Dynamic extension consisted of the maximum and minimum intensities captured by the decibel meter. The maximum phonation times of the vowels “a”,“i”,“u” were measured (seconds) after deep inspiration using a digital chronometer, with the mean value of the emissions being obtained. Data were analyzed statistically by the Pearson correlation coefficient, with the level of significance set at 5%.
Table 1 - Description of the mean, median, standard deviation (SD), minimum and maximum (Min-Max) of maximum phonation time vocal parameters in seconds (s), vocal intensity (usual, weak and strong) and dynamic extension in decibels (dB) in laryngectomee tracheoesophageal prosthesis users (n) Vocal parameter
n
Mean
Median
SD
Min-Max
Maximum phonation time
36
6,37
5,7
4,4
1,8-26
Usual vocal intensity
36
70,8
72,1
4,8
60,2-79
Maximum vocal intensity
36
77,1
76,1
5,9
65-91,5
Minimum vocal intensity
36
67,3
66,8
5,2
56,5-84
Dynamic Extension
36
11,2
10,2
5,2
2,1-24,5
Table 2 - Correlation between the vocal parameter maximum phonation time (MPT) and vocal intensity (usual, maximum and minimum) and dynamic extension in decibels (dB) in laryngectomee tracheoesophageal prosthesis users (n). Vocal parameter
n
*Coefficient
P value
MPT x Usual vocal intensity
36
0,10
0,53
MPT x Maximum vocal intensity
36
0,33
0,04
MPT x Minimum vocal intensity
36
-0,73
0,67
MPT x Dynamic extension
36
0,53
0,001
*Pearson’s Correlation Coefficient p
