Laryngo- rhino- otologie
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Laryngo- rhino- otologie · Mar 2004
[Tracheostoma valve with integrated cough lid for improvement of hands-free speech in laryngectomees - long term results].
Tracheostoma valves for laryngectomized patients were introduced to enable the laryngectomee after successful surgical voice restoration either by a voice prosthesis, a surgical shunt or microvascular laryngoplasty, to speak without using his fingers to close the tracheostoma. The basic principle of these aids is a mobile valve, which closes automatically at a certain air flow, directing the expired air of the lungs into the pharynx. In spite of the clear advantage of enabling a hands-free speech, the long term acceptance rate is still rather low, which is mainly caused by problems of an airtight fixation within or at the tracheostoma. Another important disadvantage of these tracheostoma valves is the necessity of removing the valve during coughing. The new tracheostoma valve "Window" (ADEVA Company, Lübeck, Germany) offers a clear improvement regarding this point. It is constructed with an additional coughing lid, which opens at a certain airflow and closes automatically after the coughing attack. After successful development and clinical testing of the new aid in 1999 and 2000, it was now the question, if the previously low acceptance rate of tracheostoma valves could be improved in the long term use by this new type of valve. ⋯ The "Window" tracheostoma valve with an integrated coughing lid provides further improvement in speech rehabilitation of laryngectomees. The actual rate of acceptance of 62 % for all "Window" patients (1 month daily use for at least 2 hours) is superior to other reports on the use of tracheostoma valves and probably caused by the additional comfort provided by the coughing lid. Another important factor for the long term use of tracheostoma valves is however the safe fixation of the device in or around the tracheostoma. In this point further improvement is necessary, as only the model with the fixation within the trachea (T-type) led to a satisfactory long term airtight fixation.