Speech Production and Speech with a Phrenic Nerve Pacer

A phrenic nerve pacer is a neural prosthesis used by some individuals with ventilatory insufficiency. This report provides a description of the phrenic nerve pacer and contains a case study of a young man in whom speech production during phrenic nerve pacing was examined and contrasted to that during mechanical (positive-pressure) ventilation. Results revealed that the physical mechanisms used to produce speech and the resultant speech output differed under these two ventilatory conditions. Listener judgments indicated that speech produced with a phrenic nerve pacer was strongly preferred over that produced with a mechanical ventilator, primarily because it was more continuous and contained fewer and shorter pauses. This continuity was due, in part, to a conservation-of-air strategy employed by the speaker. These observations have important clinical implications for speech-language pathologists responsible for enhancing spoken communication skills in clients requiring ventilatory support.