After a total excision of the larynx, mucosal tissue at the upper part of the esophagus can be used as a substitute voice generating element. The properties of the tissue dynamics are closely related to the substitute voice quality. The process of substitute voice is investigated by recording simultaneously the acoustic signal with a microphone and the vibrations of the voice generator with a digital high-speed camera. We propose an automatic image-processing technique which is applied to analyze the vibration pattern of the substitute voice generating element. First, an initialization step detects the voice generator within a high-speed sequence. Second, a combination of a threshold technique and an active contour algorithm tracks the tissue deformations of the substitute voice generator. The applicability of the algorithm is shown in three high-speed recordings. For the first time, tissue deformations of substitute voice generating elements are successfully tracked. The results of the image processing procedure are used to describe quantitatively the temporal properties of the substitute voice generator. Comparisons of the spectral components of tissue deformations and tracheoesophageal voice signals reveal the close relationship between the vibration pattern of the substitute voice generator and the quality of substitute voice.