Clinical Modification of the Tracheostoma Breathing Valve for Voice Restoration

Abstract

The development of the tracheostoma breathing valve and its use in conjunction with tracheoesophageal (TE) puncture prostheses has offered an important option to laryngectomized patients who undergo surgical-prosthetic voice restoration. Despite advantages that the tracheostoma breathing valve provides, some TE speakers are unable to utilize the device although they are successful users of the TE puncture voice prosthesis. This paper presents a safe, simple, and successful modification of the tracheostoma breathing valve in a single patient who demonstrated anatomical limitations for its use. Modification procedures are presented and clinical implications are discussed.

A new custom moldable external neck brace (ENB 2.0) to improve hands‐free speech in laryngectomized patients

“…However, the majority of these patients fail to use a hands-free valve on a daily basis, mainly due to fixation problems of the adhesive baseplate housing. [1][2][3] Throughout the world, the use of voice rehabilitation equipment such as heat and moisture exchangers (HME), adhesives, or tubes varies among laryngectomees. An important reason for this is the lack of medical equipment funding or reimbursement by insurance companies and health care systems, leaving patients to selffund equipment.…”

Clinical use of a neck brace to improve hands‐free speech in laryngectomized patients

“…This is mainly due to fixation problems of the adhesive housings. Peristomal fixation of adhesive baseplates is still one of the main problems that accounts for the relatively low number of laryngectomized patients who benefit from hands‐free speech facilitated by an automatic stoma valve (ASV) 1–3. Op de Coul et al3 reported Provox hands‐free HME (Atos Medical, Hörby Sweden) use for a median of 5 hours a day among daily users (only 33% of all participants) after a 6‐month trial.…”

Improving Hands‐free Speech Rehabilitation in Patients With a Laryngectomy: Proof‐of‐Concept of an Intratracheal Fixation Device

“…However, regular use of hands-free speech with an ASV is limited to only 7% to 37.5% of patients, [2][3][4][5][6][7] mainly due to problems with achieving airtight ASV fixation in the tracheostoma opening. [2][3][4][5]8,9 We have developed an intratracheal fixation device (ITFD) as a potential alternative method to improve ASV fixation and ultimately compliance. In this proof-of-concept study with 7 patients with a laryngectomy, we focused on the short-term effectiveness and experienced comfort of the ITFD.…”

“…The ASV enables patients with a laryngectomy to speak without using manual occlusion, therefore reducing the emphasis on the patient’s disability and improving hygiene and dexterity. However, regular use of hands‐free speech with an ASV is limited to only 7% to 37.5% of patients, 2–7 mainly due to problems with achieving airtight ASV fixation in the tracheostoma opening 2–5,8,9 . We have developed an intratracheal fixation device (ITFD) as a potential alternative method to improve ASV fixation and ultimately compliance.…”