Use of a “Hands-Free” Tracheostoma Valve in Patients with Laryngectomy and Tracheoesophageal Puncture

Abstract

The goals of the study were 1) to investigate the relationship between tracheal air pressure and the tracheostoma valve seal in patients with laryngectomy and tracheoesophageal puncture (TEP) and 2) to assess whether tracheal pressure contributes to the duration of the valve seal. Ten patients with TEP after laryngectomy underwent training with an outer Blom-Singer tracheostoma valve and a 30-day trial with this "hands-free" speaking valve. We found that tracheal pressure was not a significant predictor variable in assessing the duration of the outer tracheostoma valve seal achieved by the patients with TEP. Factors other than tracheal pressure appeared to affect the duration of the tracheostoma valve seal. Mastery of use of the tracheostoma valve, the subject's neck anatomy, and the amount of time, training, and experience that was given to each subject were significant predictors of the valve seal. Tracheal pressure measurements might be of use in deciding between a standard or a low-pressure outer tracheostoma valve for an individual patient.

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

“…The participants who had previous experience with the use of an ASV managed to achieve a significantly longer airtight seal (with or without ENB) of the adhesive baseplate compared to patients who had not used a hands‐free valve before (Table III). This finding is in keeping with Roxburgh and Perry 14…”

“…Roxburgh and Perry14 assessed the relation between tracheal pressures during TOP speech and adhesive loosening in a 30‐day trial with a Blom–Singer adjustable tracheostoma valve (ATV) (Inhealth Technologies, Carpinteria, CA). Their group found that tracheal pressure was not a significant predictor variable in the lifetime of an adhesive seal.…”

Primary versus secondary tracheoesophageal puncture: systematic review and meta-analysis

“…1 Benefits of tracheoesophageal puncture over other alaryngeal speech methods include longer phonation time, more syllables per breath and greater maximum intensity level. 2 More contentious, however, is the timing of the tracheoesophageal puncture. The original description of tracheoesophageal puncture insertion was as a secondary procedure in patients post-laryngectomy, but increasingly it has been performed primarily as part of the laryngectomy.…”

In vivo experiments with tracheostoma tissue connector prototypes

“…During manual occlusion, counter‐pressure is applied to balance the tracheal back pressure needed for tracheo–esophageal speech. However, one study indicated that tracheal back pressure was not a significant factor to predict valve seal attachment time of the Blom‐Singer TSV 10…”

“…However, one study indicated that tracheal back pressure was not a significant factor to predict valve seal attachment time of the Blom-Singer TSV. 10 Other disadvantages of the current fixation methods are painful skin irritation or even skin or soft tissue infection caused by skin maceration and traction, time-consuming cleaning and reattaching, noise, dislodgement, and high financial cost.…”