This study will evaluate the ability of MyoVoice to replace natural speech. Referred to generally as an Augmentative and Alternative Communication (AAC) device, MyoVoice uses electrical signals recorded non-invasively from speech muscles (electromyographic, or EMG, signals) to restore communication for those with vocal impairments that resulted from surgical treatment of laryngeal and oropharyngeal cancers.

Over 7.5 million people worldwide are unable to vocalize effectively. Among these individuals are cancer survivors who underwent oropharyngeal/laryngeal surgery and must rely on AAC systems such as text-to-speech applications or artificial voice prostheses as substitutes for their natural voice. Yet most of these devices struggle to convey the expressive attributes of speech (prosody), leading to poor comprehension and a lack of emotional content. The clinical trial will investigate the feasibility of MyoVoice-a novel AAC device that uses surface EMG signals to extract patterns for understanding vocabulary and expressive attributes from articulatory musculature during silently mouthed speech-to effectively restore conversational capabilities for individuals living with vocal impairments due to surgical treatment of laryngeal and oropharyngeal cancers. Patients who underwent a total laryngectomy will be asked to communicate with a conversational partner by silently mouthing words using MyoVoice. The device performance will be evaluated in terms of its ability to accurately and quickly translate articulatory muscle activity into audible speech. MyoVoice will also be compared to that of conventional electrolaryngeal speech aids (i.e., artificial larynx) to evaluate device ease-of-use, functional efficacy, and social reception.

1. Individuals without Laryngectomy ("Controls")

   Inclusion Criteria:

   • Primary English speaker
   • No history of speech, language, cognitive, or hearing disorders
   • Normal hearing (able to pass a bilateral hearing screening using a threshold of 25 decibels (dB) hearing level (HL) at 125, 250, 500, 1000, 2000, 4000, and 8000 Hz based on the American Speech-Language-Hearing Association)
   • Capable of signed informed consent

   Exclusion Criteria:

   • Inability to understand spoken English or follow simple instructions
   • History of speech, language, cognitive, or hearing disorders
   • Inability to provide written informed consent

2. Individuals with Laryngectomy

Inclusion Criteria:

• At least 6 months S/P total laryngectomy
• Primary English speaker
• Proficient with an electrolarynx (EL)
• Sufficiently available and healthy to comply with multiple test sessions lasting 4-6 hours
• Capable of signed informed consent

Exclusion Criteria:

• Inability to understand spoken English or follow simple instructions
• Loss of adequate surface electromyographic (sEMG) sensor sites for recording from muscles of articulation due to cancer treatment
• Skin disorders or radiation/surgical scarring that prevent the use of medical-grade adhesive tapes for securing sensors
• Any other medical or psychological condition that is based on the opinion of investigations will prevent participation in the experiment (e.g., the candidate may have an illness that makes them fatigue easily or have difficulty to attend to visual cues)
• Inability to provide written informed consent

De-identified individual participant demographics, summary data for all primary and secondary outcome measures, and study protocol will be made available.

Data will be made available within 6 months of study completion.

Data access request will be made through conferencing.