SPEECH ASSESSMENT OF PATIENTS USING 3 TYPES OF INDWELLING TRACHEOESOPHAGEAL VOICE PROSTHESES

A multidisciplinary prospective study compared speech acceptability be tween three types of indwelling tracheo-oesophageal voice prostheses. Twenty male laryngectomees took part over five years, using 42 prosthe ses. Speech was assessed on a discrete scale by trained and untrained personnel. The majority scored in the mid-range for each assessor. The kappa coefficient was used to test similarity between assessors, and for all pairings agreement was significant (p<0.05). The speech and la nguage therapist tended to give higher scores and the patient lower. A relationship was found between patients' ages categorized by decade a nd the surgeon's score alone. This relationship held for Groningen hig h resistance and Provox prostheses individually too (p<0.05). The untr ained assessed similarly to the professionals - humans are all voice l isteners. The analysis suggests surgeons find tracheo-oesophageal spee ch in older patients better than in younger ones; or make more allowan ces for the elderly. There was a trend for Provox prostheses to produc e the best scores.