8.1 Clinical Context
Laryngeal cancer treatment often requires total laryngectomy — the surgical removal of the larynx. This eliminates
the patient’s natural voice. Post-surgery, patients develop alternative voice production methods, most commonly
tracheoesophageal puncture (TEP) speech, which uses a prosthesis to divert pulmonary air into the esophagus for
phonation [9].
Current voice banking approaches record the patient’s voice before surgery and use text-to-speech synthesis to
reproduce it. However, these approaches fail to capture the patient’s internal self-perception of their voice, o nly the
external recording.
8.2 Inner Voice Approach
Our framework proposes a new protocol:
Pre-surgery: Record the patient’s voice, extract V_raw and V_perceived, compute ΔV
Post-surgery: Record the patient’s new TEP speech
Apply ΔV: Use the pre-surgery ΔV to transform the new speech, restoring not just the vocal timbre but the
patient’s internal perception
This approach preserves vocal identity and self-perception through a traumatic voice loss experience.
8.3 Ethical Considerations
Clinical application requires: – Institutional ethics board approval – Informed consent for voice data storage and
processing – Clear communication about the limitations of voice reconstruction – Patient involvement in defining what
constitutes a successful outcome
The current proof-of-concept is not clinically validated and serves only as a demonstration of the technical
framework.
