Pre- and post-operative counseling for laryngectomees and their spouses: an update.

This survey was developed to determine if pre-operative counseling services have improved since the 1978 Keith, Linebaugh, and Cox study. The questions were aimed to obtain information on the quality and quantity of support services available to laryngectomees and their spouses. Questions addressed the type, amount, and content of information received. In addition, questions regarding post-operative counseling services for laryngectomees and spouses of laryngectomees also were included. Results indicated that 21% of the laryngectomees were not aware that laryngectomy surgery would result in loss of voice. In addition, not all speech rehabilitation options were explained to the patients. Pre- and post-operative counseling services for laryngectomees continue to be inadequate. It appears that little change has been made to improve this situation.

The Lombard effect on alaryngeal speech.

The need to train alaryngeal speakers to use increased vocal intensity has been noted in the literature. One untested technique is to evoke an intensity increase by applying masking noise to the ears of the talker. The purpose of this study was to investigate the Lombard effect on the speech of esophageal talkers, artificial larynx users, and normal speakers. The subjects read aloud a variety of materials first in quiet then while being subjected to 100 dB SPL noise delivered through earphones. The resulting sound pressure values were obtained by measuring the peak values of all syllables spoken by each talker. The results indicated that the esophageal talkers produced the highest intensity increase in the noise condition followed by the normal talkers and the artificial larynx talkers. Coarticulatory and duration effects on alaryngeal and normal speech are also reported. Clinical implications are discussed.