Noninvasive Speech Restoration After Total Laryngectomy Using Surface Electromyography: Pilot Study

Vollständiger Abstract

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ABSTRACT Objective To demonstrate the feasibility of restoring intelligible, own‐voice speech after total laryngectomy using noninvasive surface electromyography. Methods One post‐laryngectomy patient and one healthy reference speaker silently articulated a closed‐vocabulary corpus of 499 dates and times while surface electromyographic (sEMG) signals were recorded from a 20‐electrode face, jaw, and neck montage. A decoder mapped sEMG into speaker‐independent speech tokens, which a public token‐to‐speech stack converted into audible speech; for the patient, the output was re‐rendered in his own pre‐surgical voice using approximately 8 min of audio recorded before surgery. A per‐subject procedure identified a reduced electrode subset, and performance was evaluated by five human listeners. Results The system produced intelligible speech in the patient's own pre‐surgical voice. Mean word error rate by human listeners was 20.2% (95% CI 11.0%–31.5%) for the patient and 14.9% (6.8%–24.9%) for the reference speaker. Electrode‐selection analysis indicated that roughly half of the recorded electrodes captured 95% of the multi‐channel signal (9 of 20 for the patient, 11 of 18 for the reference), supporting more compact hardware. Single‐trial recordings showed coordinated muscle activity tracking each silently articulated word despite the absence of phonation. Conclusion Noninvasive sEMG‐based speech restoration is feasible after total laryngectomy. By decoding muscle activity into a speaker‐independent representation, the approach sidesteps the absence of post‐surgical own‐voice audio and remains applicable to patients unable to phonate. Unlike existing alternatives (electrolarynx, esophageal speech, tracheoesophageal puncture), it can also restore the patient's own pre‐surgical voice, offering a high‐performing, low‐complication path toward clinical use. Level of Evidence 4.