title: [Finger-free speech with the Provox FreeHands HME Automatic Tracheostoma Valve system. Clinical long-term experience].
abstract: BACKGROUND
  The use of voice prostheses allows excellent rehabilitation of laryngectomized patients but it is considered a disadvantage that the tracheostoma must be closed manually for speech production. This limits their ability to simultaneously communicate by gestures or to work with both hands. An automatic tracheostoma valve helps patients to overcome this problem.
  
  
  METHODS
  A total of 17 laryngectomized patients were asked to join a long-term study 18 months after having been fitted with a Provox FreeHands HME Automatic Tracheostoma Valve system. The patients completed a questionnaire in order to assess satisfaction, voice quality, wearing comfort, fixation, potential problems and the effectiveness of the HME cassette.
  
  
  RESULTS
  Of the 17 patients 4 discontinued the study due to problems of securing the valve to the skin (n=2) or fistula leakage (n=2). Of the remaining patients 7 wore the valve daily for an average of 6 h. Of the patients 76% considered it a great advantage to be able to speak without using their hands. With the Provox FreeHands HME Automatic Tracheostoma Valve system, maximum phonation time was 8.5 s (+/-6.8) and the dynamic range was 21.7 decibels (+/-5.6).
  
  
  CONCLUSIONS
  The results show that the Provox FreeHands HME Automatic Tracheostoma Valve system not only allows hands-free speech but is also associated with excellent long-term compliance and good voice rehabilitation.
authors: Abteilung für Hals-Nasen-Ohren-Heilkunde, Kopf-Hals-Chirurgie, Bundeswehrkrankenhaus Ulm, 89081 Ulm. kai.lorenz@extern.uni-ulm.de
authors: K J
authors: KJ
authors: Lorenz
authors: K
authors: K
authors: Huverstuhl
authors: H
authors: H
authors: Maier
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007825:Laryngectomy / Q000534:rehabilitation*; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011474:Prosthesis Design; D014139:Tracheostomy / Q000295:instrumentation*