2022 Volume 63 Issue 2 Pages 143-148
Critically ill patients undergoing mechanical ventilation often suffer from psychological distress due to the loss of speech. We present a tracheostomized patient who was able to produce intelligible speech with a combination of an electrolarynx (EL) and above cuff vocalization (ACV).
A 70-year-old man underwent a tracheostomy and required long-term mechanical ventilation due to tracheal deformation after lung cancer surgery. To enhance communication for the patient, we applied an EL and ACV. Speech intelligibility was evaluated by the 9-point conversational intelligibility test. The speech intelligibility score was 4 with the EL, and 4 with ACV, because the patient was only able to tolerate a low airflow rate (1 L/min). We subsequently applied a combination of the EL and ACV. The combination method increased speech intelligibility up to 2.5 and improved patient satisfaction as evaluated by the visual analog scale.
For EL users, voiceless consonants are difficult to pronounce and are one of the causes of poor intelligibility. Adding ACV to the use of EL might allow the patient to pronounce such voiceless consonants and possibly lead to improved speech intelligibility. Our findings suggest that it may be useful to use an EL together with ACV to communicate with tracheostomized patients.
