IntROduCtIOn Tracheo-oesophageal speech is one of the most commonly used alaryngeal voice modes for individuals undergoing total laryngectomy due to laryngeal cancer. Laryngeal cancer contributes to approximately 3-6% of all cancer in Indian males and only about 0.2-1% of all cancers in females (ICMR, 2013) [1]. In TE speakers, appropriate sized voice prosthesis is fitted into TE Puncture (TEP) for voice production [2] . The voice source (neoglottis) characteristics of TE speakers have been

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... ctively studied and there is an increasing focus towards cepstral analysis of TE voice. Cepstral measure i.e., CPP is a more reliable measure of periodicity and implies on voice quality in an objective and quantifiable way [3] [4] [5][6]. In TE speakers, due to a periodic nature of the neoglottic vibration, CPP is more preferred to objectively quantify the overall voice quality [7, 8] . There are differences present between Blom-Singer non-indwelling low pressure and classic indwelling voice prosthesis in terms of mode of fitting (non-indwelling versus indwelling), prosthesis design (size of the tracheal and oesophageal flanges, prosthesis tip and silicon grade used), valve opening pressure and cost of the voice prostheses. Valve opening pressure is reported to influence the device life [9]. In developing countries like India, cost is a major factor in patient decision of prosthesis selection, as most often, it is not covered under health insurance. Findings on voice quality differences in same TE speaker with two different voice prosthesis would substantiate the decision making during the selection of the voice prostheses for both clinicians and patients. It would provide additional information to the clinician justifying the cost of the device especially at the time of counselling. Hence, the objective of the current study was to compare the CPP between Blom-Singer non-indwelling low pressure and classic indwelling voice prosthesis across vowel phonation /a/ and text-reading tasks in male TE speakers. MAtERIALS And MEthOdS This is a comparative study with cross-over study design carried out at Participants: The clinical group consisted of 10 male TE speakers in the age range of 45-75 years. Participants who were referred from the head and neck surgeon were considered for the study. Participants who underwent total laryngectomy during two years time frame before the commencement of the study were considered. Participants who had undergone secondary TEP following total laryngectomy with catheter in place for 48 hours were referred to Speech-Language Pathologist (SLP). Patients with respiratory complaints, hearing problem, psychological and neurological problems, habits of cigarette smoking, alcohol intake, heavy exposure to chemicals and who have undergone chemotherapy/ radiation post-total laryngectomy were excluded. The study was commenced after approval from Institutional Ethics Committee (IEC 245/2014). Prior to data collection, a signed 'consent form' and 'subject information sheet' were obtained. Data collection: Blom-Singer non-indwelling low pressure and classic indwelling voice prosthesis were used in the study. Nonindwelling type requires removal, cleaning and re-insertion on a daily basis or at least every 3-4 days, by the patient or caregiver. The indwelling type of voice prosthesis is generally fitted by a trained SLP and does not require frequent removal and insertion, can stay in place for 3-6 months [10] . For all participants, first prosthesis to be fitted was selected on the basis of randomisation using 'research randomizer' programme. Participants could see the voice prosthesis, ABStRACt Introduction: Tracheo-oesophageal (TE) speech is one of the most commonly used alaryngeal voice restoration options for individuals who have undergone a total laryngectomy. Cepstral Peak Prominence (CPP) implies the overall voice quality objectively.