ABSTRACT
BACKGROUND AND OBJECTIVES: Advanced laryngeal cancer is frequently treated by total laryngectomy. This operation is effective but results in gross functional disability because of the permanent loss of voice. As an alternative using voice, esophageal speech has been employed as a natural and satisfactory means of communication for laryngectomized patients. Unfortunately, during past decades the success rate has ranged 40-60%. The purpose of this study was to determine which factors contribute to the proficiency of esophageal speech. MATERIALS AND METHOD: Videofluoroscopy and voice analysis of fourteen alaryngeal male patients who had trained esophageal speech were performed. RESULTS: Aerophagia and air ejection were impossible in poor esophageal speakers. Fluent esophageal speakers had short pseudoglottis, longer maximum phonation time, more efficient jitter, shimmer and harmonic-to-noise ratio. CONCLUSION: Aerophagia and air ejection are essential for esophageal speech. Short pseudoglottis (less than 2 cm) affords better esophageal speech. Natural repetitive movements of aerophagia and air ejection with accurate articulatory motion can improve the quality of esophageal speech.