INTELLIGIBILITY AND PERCEPTUAL RATINGS AFTER TREATMENT FOR LARYNGEAL-CANCER - LARYNGECTOMY VERSUS RADIOTHERAPY

In Sweden the most common treatment for T3-T4 laryngeal carcinoma is r adical radiotherapy (with surgery for salvage), because the voice is t hus preserved. A Swedish study showed that surgery yielded a significa ntly better 5-year survival and locoregional control at 3 years in T4 laryngeal carcinoma than radical radiotherapy. With these results in m ind, we wanted to compare the different modes of treatment (surgery wi th a tracheoesophageal [TE] fistula and radical radiotherapy) with res pect to the patients' speech proficiency. Twenty-eight subjects (with 14 patients in each treatment group) were judged by inexperienced and experienced listeners according to intelligibility by transcription an d three perceptual ratings. From the perceptual ratings of speech inte lligibility, voice quality, and speech acceptability we conclude that there is a significant difference, the irradiated speakers being rated higher that the tracheoesophageal speakers. It is also clear that mos t of the TE and irradiated laryngeal speaking patients are comparable to normal laryngeal speakers in intelligibility by transcription. Expe rienced and inexperienced listeners are able to rate TE and irradiated laryngeal speech reliably and similarly according to intelligibility by transcription. The inexperienced listeners rated the TE speakers si gnificantly higher than did the experienced listeners.