Clinical Experiences of People With a Laryngectomy During the SARS COVID-19 Pandemic

Purpose This study described the clinical experiences of patients with a total laryngectomy (TL) during the COVID-19 pandemic and identified changes in communication, tracheostoma care, and heat–moisture exchange (HME) use that were recommended or self-implemented. Method An online survey addressing the study aims was completed by 173 people with a TL who live in the United States. The survey was open from July 5 to August 10, 2020. Results In-person clinic visits, appointment cancellations, and contact from their speech-language pathologists (SLPs) were reported by 42%, 19%, and 54% of the TL respondents, respectively. At clinic visits, 78% were required to wear a mask over their nose/mouth, and 73% were required to wear a mask over their tracheostoma. Masks, gloves, and face shields worn by the SLP at these visits were reported by 84%, 82%, and 70% of the TL patients, respectively. Alaryngeal communication changes were recommended by the SLP for 7%–18% of TL patients, depending on their method of communication, whereas 43%–45% implemented changes on their own. Changes in tracheostoma care and HME use were recommended by the SLP for 27% and 21% of the TL respondents, respectively, whereas 54% and 47% made changes on their own. Conclusions Individuals with a TL will require in-person care even during a pandemic, as reflected in this study. Many had not been contacted by their SLP or otolaryngologist about TL guidelines that were becoming available. Notably, larger percentages of TL patients reported self-initiated changes to their communication, tracheostoma care, and HME use because of the pandemic than their SLP had advised. The types of communication changes varied in part, depending on the method of alaryngeal speech a respondent used. Supplemental Material https://doi.org/10.23641/asha.16807270

PHONETOVOX: A Novel Prototype Device for Alaryngeal Speech

Objective: To describe a prototype improvised hand held device for alaryngeal speech. Methods: Design: Instrument Innovation Setting: Tertiary Private Hospital Participants: Four listeners with normal hearing, were native Tagalog-speakers and had no previous experience with alaryngeal speech types participated in initial trials. Results: The prototype PHONETOVOX was fabricated using a soundproofed cellphone casing with an intra-oral sound port attachment and a cellphone was loaded with Pocket Talkbox v. 1.4.0 software. The device was tested for its ability to produce intelligible speech by using the cellphone as a substitute for the larynx using oral cavity resonators and articulators, producing a synthesized sound mimicking the human voice. The PHONETOVOX produced intelligible words. Initial testing using a C-V-C Tagalog Word List had 4 listeners identify 34, 35, 47, and 54 out of 93 words (37 to 58%), with an overall average intelligibility of 46%. Conclusion: Despite its restrictions in articulation and the wide range of results from the four listeners, our initial results may suggest the potential of PHONETOVOX as another modality for alaryngeal speech comparable to the 36 – 38 % intelligibility of commercially-available devices. Further trials with actual laryngectomees are needed to further establish intelligibility and acceptability. Keywords: Laryngectomy, Alaryngeal speech, Laryngeal Cancer