title: Automatic speaking valve in speech rehabilitation for laryngectomized patients.
abstract: For speech rehabilitation after total laryngectomy, the Provox FreeHands Heat and Moisture Exchanger (FreeHands HME; Atos Medical AB, Hörby, Sweden) was compared with the Provox Heat and Moisture Exchanger (HME), and the patients' Health-Related Quality of Life (HRQoL) was assessed. A review of the English literature was performed considering automatic speaking valves. The study design was a cohort study. Fourteen laryngectomized male patients who had used the HME successfully before receiving the FreeHands HME entered the study. An ENT specialist and a speech pathologist examined these patients. Data concerning voicing, breathing, skin adhesion, voice and speech quality, and HRQoL were collected by a structured questionnaire. Voice recordings were performed for evaluation of the quality of the voice. A computer-aided search of the MED-LINE database was conducted, supplemented by hand searches of key journals. Twelve patients had used the FreeHands HME on special social occasions and reported three main reasons why FreeHands HME was unsuitable for continuous use: heavier breathing, more difficult speaking, and worse subjective quality of voice. With HME, phonation time tended to be longer and the softest phonation softer ( P =0.034). The loudest phonation was louder with FreeHands HME ( P =0.015). Patients' HRQoL assessed by the 15D profile was similar to that of the age- and sex-matched male Finnish general population (patients 0.877, population 0.884). A review of the literature showed few works dealing with automatic speaking valves. The FreeHands HME is a useful additional device in a selected group of laryngectomized patients. Total laryngectomy did not lower patients' HRQoL notably.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Central Hospital, P.O. Box 220, 00029 HUS, Helsinki, Finland. hanna.tervonen@hus.fi
authors.forename: Hanna
authors.initials: H
authors.lastname: Tervonen
authors.forename: Leif
authors.initials: L
authors.lastname: Bäck
authors.forename: Anja
authors.initials: A
authors.lastname: Juvas
authors.forename: Pirjo
authors.initials: P
authors.lastname: Räsänen
authors.forename: Antti A
authors.initials: AA
authors.lastname: Mäkitie
authors.forename: Harri
authors.initials: H
authors.lastname: Sintonen
authors.forename: Risto P
authors.initials: RP
authors.lastname: Roine
authors.forename: Erkki
authors.initials: E
authors.lastname: Vilkman
authors.forename: Leena-Maija
authors.initials: LM
authors.lastname: Aaltonen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000534:rehabilitation*; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D010699:Phonation; D011788:Quality of Life; D012119:Respiration; D013068:Speech Production Measurement; D013071:Speech, Alaryngeal / Q000295:instrumentation*; D011795:Surveys and Questionnaires; D013637:Tape Recording; D014833:Voice Quality
references.citation: Head Neck. 2001 Jan;23(1):16-24
references.pmid: 11150066
references.citation: ORL J Otorhinolaryngol Relat Spec. 1995 May-Jun;57(3):165-70
references.pmid: 7603697
references.citation: Ann Med. 2001 Jul;33(5):328-36
references.pmid: 11491191
references.citation: Folia Phoniatr Logop. 2003 Sep-Oct;55(5):211-9
references.pmid: 12931055
references.citation: Ann Med. 2001 Jul;33(5):358-70
references.pmid: 11491195
references.citation: Ann Otol Rhinol Laryngol. 2003 Dec;112(12):1007-10
references.pmid: 14703101
references.citation: Clin Otolaryngol Allied Sci. 1996 Oct;21(5):414-8
references.pmid: 8932945
references.citation: Int J Radiat Oncol Biol Phys. 1983 Mar;9(3):335-8
references.pmid: 6841185
references.citation: Qual Life Res. 1999;8(1-2):45-54
references.pmid: 10457737
references.citation: Ann Otol Rhinol Laryngol. 1999 Oct;108(10):990-7
references.pmid: 10526855
references.citation: Acta Otolaryngol. 2003 Jan;123(1):91-9
references.pmid: 12625581
references.citation: Laryngoscope. 1998 Feb;108(2):257-60
references.pmid: 9473078
references.citation: Ann Otol Rhinol Laryngol. 1995 Oct;104(10 Pt 1):763-9
references.pmid: 7574252
references.citation: Laryngoscope. 2004 Apr;114(4):753-9
references.pmid: 15064636