Table of Contents:
- What is esophageal voice?
- What is esophageal voice used for?
- What is esophageal voice?
- How is the patient prepared and trained?
- Evaluation of esophageal voice
- Esophageal voice alternatives
What is esophageal voice?
The term “esophageal voice” was coined in 1910. It is the voice formed by the swallowing of air into the esophagus and its controlled expulsion learned by laryngectomized patients for rehabilitation. This type of voice is produced when the swallowed air passes through the middle and lower pharyngeal constrictor sphincter resulting in a natural sphincter.
It is a technique that uses the body’s tissues as a new speech source. It requires the patient to produce certain amounts of air in the esophagus so that it vibrates, generating a sound that is then modified by movements of the tongue and lips.
The goal is to articulate between 4 and 9 syllables per breath and thus speak at a rate of 80 to 129 words per minute.
Why is it performed?
This procedure is usually performed on patients who have undergone a laryngectomy, i.e. surgery to remove part or all of the larynx. This type of intervention is required in cases of laryngeal cancer in advanced stages, when a loss of voice usually appears.
The aim of this type of technique is to enable the patient to communicate by means of an alternative source of sound production.
What does esophageal voice consist of?
The esophageal voice or erigmophony technique consists of introducing air into the esophagus and then allowing it to come out, in a controlled manner. In this way, the pharyngoesophageal region is vibrated and sounds are produced that can be used as a source of communication, which must then be shaped by the suprabocal tract.
The key and difficulty in achieving this technique and smooth communication is the intake of sufficient air to be able to overcome the upper esophageal sphincter.
How is the patient prepared and trained?
The procedure is initiated by asking the patient to draw in air and produce a single esophageal sound. In addition, the patient should be tested for natural burping.
Three methods of esophageal voice rehabilitation are distinguished: the swallowing method, the suction method and the injection method.
- Swallowing method
Air is introduced into the pharynx with swallowing movements. That is to say, when the introduction of air into the esophagus is perceived, it must be expelled by emitting a vowel.
- Aspiration method
Air is introduced into the esophagus through a forced suction movement. In this method it is easier to introduce the air through a deep inspiration, although it is a more difficult technique, since it requires greater muscular control.
- Injection method
This is the combination of two techniques: on the one hand, injection by glossopharyngeal pressure and, on the other hand, consonantal injection.
That is to say, the lips must be pressed together and the tongue against the palate. The tongue is then forcefully raised and retracted to compress the air in the pharyngeal cavity. With the help of the neck muscles, air compression occurs and the esophageal region is elevated.
Evaluation of esophageal voice
In order to evaluate the patient’s rehabilitation, it should be taken into account if the person constantly uses this type of technique or if it has not been possible to use the esophageal voice to communicate.
There are some factors that influence the rehabilitation of the laryngectomized patient: age, marital status, number of children, work activity and patient history.
Alternatives to this treatment
In some cases, the source of sound production can be sought to achieve communication by means of artificial larynx techniques or phonatory fistula devices.