Proceedings Invitational Round Table “Evidence-based Voice and Speech Rehabilitation in Head and Neck Cancer” May 15-16, 2008 Amsterdam Organization Department of Head and Neck Oncology and Surgery The Netherlands Cancer Institute, Amsterdam Institute of Phonetic Sciences/ Amsterdam Center for Language and Communication University of Amsterdam Department of Otorhinolaryngology Academic Medical Center, University of Amsterdam Organizing Committee Prof. Dr. Frans JM Hilgers Prof. Dr. Ir. Louis CW Pols Dr. Maya van Rossum Dr. MWM van den Brekel Venue: Netherlands Cancer Institute, Amsterdam Program Invitational Round Table “Evidence-based Voice and Speech Rehabilitation in Head and Neck Cancer” Thursday May 15, 2008 Chairpersons Frans Hilgers, Louis Pols 13.15: Welcome with coffee 13.30-13.45: Opening. Frans Hilgers, Louis Pols 13.45-14.45: Perceptual and acoustic analysis of TE-substitute voice and speech. Corina van As-Brooks 14.45-15.45: Objective evaluation of TE-substitute voice and speech. Ulrich Eysholdt 15.45-16.00: Tea break 16.00-17.00: Articulatory aerodynamics, contact pressures and sense of effort during tracheoesophageal speech. Jeff Searl 17.00-17.45: Poster presentations and poster visit* 1. Tracheoesophageal speech with manual versus automatic stoma occlusion: a multi-dimensional comparison. Annelies Labaere et al. 2. Early rehabilitation of Head and Neck Cancer patients at Karolinska University Hospital. Therese Engström et al. 19.00-22.00: Dinner Friday May 16, 2008 Chairpersons Maya van Rossum, Annemieke Ackerstaff 09.00-10.00: An evidence-based rehabilitation program for tracheoesophageal speakers. Petra Jongmans 10.00-11.00: Quality of life after Total Laryngectomy. Tanya Eadie 11.00-11.15: Coffee break 11.15-12.15: Oral and oropharyngeal cancer: speech outcomes and the need to monitor change over time. Phillip Doyle The final hour; chairpersons Frans Hilgers, Louis Pols 12.15-13.15: Where do we stand and what are the priorities for research in the near future? 13.15: Adjourn; sandwiches on the go. All presentations 45 minutes, 15 minutes discussion * Poster presentations: 15 minutes followed by discussion 2 Table of Contents Introduction........................................................................................................7 Perceptual and acoustic analysis of TE-substitute voice and speech. Corina van As-Brooks ...................................................................................................8 Abstract..........................................................................................................8 1. Introduction ................................................................................................8 2. Equipment and Methods............................................................................8 2.1. Recording equipment and environment...............................................8 2.2. Speech samples..................................................................................9 2.3. Software programs..............................................................................9 3. Results of acoustic analyses in alaryngeal speakers...............................10 3.1. Spectrographic analysis ....................................................................10 3.2. Acoustic parameters..........................................................................11 4. Acoustic measures and perceptual relevance .........................................12 4.1 Perceptual evaluation.........................................................................12 4.2 Relationships between perceptual evaluations and acoustic measures .................................................................................................................13 5. Conclusion ...............................................................................................13 6. References ..............................................................................................14 Objective evaluation of TE-substitute voice and speech. U Eysholdt, M Schuster, J Lohscheller, F Rosanowski...........................................................15 Abstract........................................................................................................15 1. Real time endoscopy of the vibrating PE segment ..................................15 2. Quantification of speech intelligibility by means of a computerized speech recognition system.......................................................................................16 3. Rating of the laryngectomees’ quality-of-life in relation to his substitute voice ............................................................................................................16 4. References ..............................................................................................17 Articulatory aerodynamics, contact pressures and sense of effort during tracheoesophageal speech. Jeff Searl ............................................................19 Abstract........................................................................................................19 1. Introduction ..............................................................................................20 2. Patients/Materials and Methods...............................................................23 2.1. Subjects ............................................................................................23 2.2. Speech Stimuli ..................................................................................24 2.3. Instrumentation and Measures..........................................................25 2.3.1. Articulatory Contact Pressure (ACP) ..........................................25 2.3.2. Oral Air Pressure (Po) ................................................................25 2.3.3. Subneoglottic Air Pressure (Psub)..............................................26 2.3.4. Sense of Effort (SOE) .................................................................28 3 2.4. Procedures........................................................................................28 3. Results.....................................................................................................29 3.1. Data Collapse....................................................................................29 3.2. Pressure Measurements ...................................................................29 3.2.1. Articulatory Contact Pressure .....................................................29 3.2.2. Oral Air Pressure ........................................................................30 3.2.3. Subneoglottic Air Pressure .........................................................30 3.3. Sense of Effort ..................................................................................30 3.1.1. Consistency of Ratings ...............................................................30 3.3.2. Magnitude of Overall SOE ..........................................................31 3.3.3. Locus ..........................................................................................31 3.3.4. Differences in Pressure Measures as a Function of Effort Rating .............................................................................................................31 3.4. Correlational Analysis........................................................................32 4. Discussion and Conclusions....................................................................33 4.1. Pressure Measurements ...................................................................34 4.1.1. Articulatory Contact Pressure .....................................................34 4.1.2. Oral Air Pressure ........................................................................34 4.1.3. Subneoglottal Pressure ..............................................................35 4.2. Sense of Effort and Relationship among Measurements ..................35 4.3. Future Directions...............................................................................37 5. Acknowledgements..................................................................................37 6. References ..............................................................................................38 An evidence-based rehabilitation program for tracheoesophageal speakers. Petra Jongmans, Maya van Rossum, Corina van As-Brooks, Frans Hilgers, Louis Pols........................................................................................................41 Abstract........................................................................................................41 1. Introduction ..............................................................................................42 2. Patients/Materials and Methods...............................................................44 2.1.Subject selection ................................................................................44 2.2. Recordings ........................................................................................44 2.3. Pre and post tests .............................................................................44 2.3.1. Phoneme and sentence intelligibility tests ..................................45 2.3.2. Semantic scaling and study-specific, structured questionnaires.46 2.4. Statistics............................................................................................47 2.5 Praat...................................................................................................47