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which is completed by a trained listener. Voice rating by untrained listeners occurs rarely (Van der Torn, Verdonck-de Leeuw et al. 2002). One review on the effect of chemoradiotherapy on voice and speech shows that the assessment of voice quality has not been standardised, that differences in the use of assessment methods and points of measurement are unacceptably big, and that assessment is often limited to one dimension (Jacobi, van der Molen et al. 2010). The most commonly used method of assessment is the patient questionnaire (Jacobi, van der Molen et al. 2010). Although this is the easiest and fastest method for collecting quality-of-life data, their outcome does not necessarily reflect the actual physical status of the patient, nor do they always give a clear clinical indication. In addition to subjective assessment of voice quality, objective assessment methods are therefore essential. None of the dimensions are found to be superfluous and a multidimensional protocol for the assessment of voice is recommended (Orlikoff, Kraus et al. 1999, Dejonckere, Bradley et al. 2001, Meleca, Dworkin et al. 2003, Friedrich and Dejonckere 2005, Jacobi, van der Molen et al. 2010). In order to carefully map out the voice, the protocols of, e.g., Verdonck-de Leeuw (Verdonck-de Leeuw, Hilgers et al. 1999), Meleca (Meleca, Dworkin et al. 2003) or Dejonckere (Dejonckere, Bradley et al. 2001) may be used. These are all multidimensional protocols including both subjective and objective analyses. The protocols involve the assessment of voice characteristics through the use of perceptual analysis by a professional listener, as well as the acoustic analysis of extended /a/ and the analysis of a videolaryngoscopy. Recently, advancements have been made in the automatic analysis of phonation (Middag, Clapham et al. 2014). In addition to the methods described above, the phonation of laryngectomy patients can be assessed through videofluoroscopy and high-speed imaging (Ward and Van As 2014). Videofluoroscopic imaging allows for the analysis of TE speech and the PE segment (Van As, Op de Coul et al. 2001). With the help of high-speed digital imaging an assessment can be made of vibrations of the neoglottis (Van As, Tigges et al. 1999).\u000D5.3.2.3 Voice therapy\u000DAfter surgical treatment with (partial) conservation of the larynx or organ preserving treatment, the main therapeutic goal is to maximise the remaining function of the larynx (Ward and van As-Brooks 2007). Early on, studies have shown the importance of rehabilitative and preventive voice therapy alongside radiotherapy (Fex and Henriksson 1969, Lehman, Bless et al. 1988). Therapy includes therapeutic techniques such as breathing, pitch, relaxation, resonance and voice production exercises (Starmer, Tippett et al. 2008). Furthermore, several swallowing exercises, such as laryngeal adduction exercises, have proven to be useful in restoring the voice function (Ward and van As-Brooks 2007). Due to the close correlation between xerostomia and voice disorders, improving hydration in the oral cavity and the pharynx is an essential component of voice therapy (Starmer, Tippett et al. 2008). In a study by Hocevar-Boltezar et al. a significant correlation was found between patients (treated for a small head and neck tumour with radiotherapy) with a hoarse voice and dry throat, and smoking (Hocevar-Boltezar, Zargi et al. 2009). Part of the voice therapy here involves giving advice, such as on reducing the use of dehydrating products such as alcohol and coffee as much as possible. The use of saliva-stimulating products may also help, such as chewing gum and candy, as will artificial saliva, dental hygiene products, steam inhalers or frequent sips of water (Starmer, Tippett et al. 2008). The advice helps to improve the hydration of the oral mucosa and, as a result, the voice quality as well (Verdolini, Titze et al. 1994, Verdolini, Min et al. 2002).\u000DPatients who have undergone a laryngectomy, including not only the removal of the voice organs, but also the separation of the upper and lower respiratory tracts, must learn to speak with a substitute\u000D109\u000D