Evaluating the effect of different voice prostheses on alaryngeal voice quality

Objective Methods To investigate the difference between voice prostheses in terms of voice quality as experienced by patients and as judged by expert raters. Subjects had up to six voice prostheses placed in a random order. A voice sample was elicited for each patient on each prosthesis. Auditory perceptual voice analysis of each voice sample was undertaken by expert raters using the Sunderland Tracheoesophageal Voice Perceptual Scale (SToPS). Raters also identified the best overall prosthesis for voice for each patient. Raters were blinded to patient details, type of laryngectomy surgery, type of voice prosthesis, and scores of other raters. After each prosthesis trial, patients self-evaluated voice using a questionnaire developed for this purpose. Results Conclusion Expert raters were not able to identify a best overall voice prosthesis using SToPS. Expert raters most frequently chose the Blom-Singer Classic Indwelling (InHealth Technologies, Carpinteria, CA) as the overall best prosthesis for voice for each patient. Patient self-evaluation scores indicated a preference for the Blom-Singer Classic Indwelling Prosthesis (InHealth Technologies) for voice, whereas preference for best overall prosthesis was for the Provox NID (Atos Medical AB, Horby, Sweden) Expert raters did not identify a best prosthesis for voice using SToPS, although the Blom-Singer Classic Indwelling (InHealth Technologies) was most frequently chosen as best for voice. Patient self-evaluation indicated a difference between preference of prosthesis for voice and preference for best overall voice prosthesis. Individual patients had their own personal preferences, suggesting they should be involved in the choice of their voice prosthesis. Level of Evidence 4. Laryngoscope, 2460-2466, 2018