Neoglottic vibration in tracheoesophageal shunt phonation

The purpose of the present study was to examine vibratory patterns of the n eoglottis and to ascertain the neoglottic conditions that could cause failu re in tracheoesophageal shunt phonation. We studied 30 tracheoesophageal sh unt speakers while using "trap-door" type voice prostheses. Videostroboscop y was undertaken to investigate vibratory patterns of the neoglottis during phonation of the sustained vowel sound /e/ in these patients. The voice qu alities of the patients were judged perceptually. A regular neoglottic vibr ation was observed in 21 patients. Nine patients had irregular neoglottic v ibrations. In this latter group, two patients had incomplete neoglottic clo sures with breathy voices, four patients had multiple contacts of several m ucosal walls with rough voices, and three patients had tight neoglottic clo sures with strained voices. During stroboscopic evaluation of tracheoesopha geal shunt phonation, regularity of the neoglottic vibration may be the mos t significant finding. These findings show that it is as important to evalu ate neoglottic vibration in alaryngeal voicing as it is to study glottic vi bration in laryngeal voicing. Stroboscopic examination may be a help to elu cidate a cause of failure in cases of poor tracheoesophageal shunt speech.