Tracheoesophageal Voicing Following Resistance-Based Dysphagia Rehabilitation: An Exploratory Multidimensional Assessment

Abstract

Background: This exploratory study investigated tracheoesophageal voicing following 6 weeks of resistance-based dysphagia rehabilitation with the SEA2.0, using a multidimensional assessment approach. Methods: Twenty laryngectomized participants were assessed at T0 (baseline), T1 (after 6 weeks training), and T2 (after 8 weeks rest). Training included the chin tuck, jaw opening, and effortful swallow against resistance. Multidimensional assessments included acoustic analysis (AVQI, intensity, dynamic range), clinician-rated perceptual evaluations (voice tonicity, intelligibility), PROMs (VHI-10, V-RQOL, CPIB-10), and tracheal manometry and pharyngeal-/esophageal high-resolution impedance manometry during voicing. Results: No significant changes in mean AVQI, intensity, dynamic range, voice tonicity, intelligibility, PROMs, and physical outcomes (manometry) were found. However, several clinically relevant changes, mostly improvements, were noted in 14 participants for AVQI and PROMs. Conclusion: Tracheoesophageal voice, on average, is not affected by resistance-based muscle training for swallowing rehabilitation. For some participants, however, several clinically relevant improvements in voice quality and quality of life were noticeable.