title: Drilling speaking valves: a modification to improve vocalization in tracheostomy dependent children.
abstract: Pediatric tracheostomy dependence is associated with a variety of sequelae. Vocalization delay is commonplace and may result in long-term communication disability. Passy-Muir speaking valves are routinely used to allow such children to vocalize. Unfortunately, not all tracheostomy dependent children can tolerate the placement of a speaking valve. Elevated transtracheal pressures are often associated with failure. We describe a method of modifying a standard Passy-Muir valve to decrease transtracheal pressures and thus improve tolerance of the valve. In our practice, the modification allows a broader range of children experience the benefit of speaking valve placement.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA. matt.brigger@alumni.vanderbilt.edu
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Brigger
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hartnick
mesh_terms: D004864:Equipment and Supplies; D006801:Humans; D007223:Infant; D008297:Male; D011312:Pressure; D013060:Speech; D013065:Speech Intelligibility; D014139:Tracheostomy / Q000295:instrumentation*