title: Three-dimensional stereophotogrammetrical analysis of peristomal fixation of adhesive base plates during hands-free speech among laryngectomised patients related to tracheostoma volumes.
abstract: OBJECTIVE
  This study evaluates the relation between stoma volumes by means of objective three-dimensional measurements of laryngectomised individuals and peristomal fixation of adhesive baseplates during hands-free speech.
  
  
  METHODS
  A three-dimensional stereophotogrammetrical image was captured of the tracheostoma and its surrounding tissue for each participant. The placement of a baseplate adhesive was virtually simulated. Individual stoma volumes were calculated and related to the duration of lifetime of adhesive baseplates.
  
  
  METHODS
  Prospective trial in a university hospital setting.
  
  
  METHODS
  Twenty-four laryngectomised patients.
  
  
  METHODS
  Stoma volume in cm(3) and adhesive baseplate adherence in minutes.
  
  
  RESULTS
  For the 24 three-dimensional images captured, the mean volume of the area under the adhesive (stoma volume) was 9.5 cm(3) (range 3.5-22.5). After relating the different volumes of all patients to their individual fixation score, a significant decrease in duration of adhesive lifetime was found with increasing volumes of the stoma (P = 0.001). An increase of 1 cm(3) in tracheostoma volume resulted in a decrease of 21% in median adhesive lifetime (95% confidence interval 10-31%).
  
  
  CONCLUSIONS
  Longer lifetime of the adhesive baseplate in patients with smaller volume outcomes suggests that a more accurate fit between baseplate and stoma leads to better fixation. This should be taken into account when shaping a stoma during laryngectomy. On the other hand, a more custom-made patch that has a more accurate fit could increase the lifetime of fixation. We believe that our three-dimensional volumetric data can contribute to the development of such an adhesive.
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, Nijmegen - Bruges, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. r.dirven@kno.umcn.nl
authors.forename: R
authors.initials: R
authors.lastname: Dirven
authors.forename: Y
authors.initials: Y
authors.lastname: Wouters
authors.forename: R
authors.initials: R
authors.lastname: Vreeken
authors.forename: T J J
authors.initials: TJ
authors.lastname: Maal
authors.forename: H A M
authors.initials: HA
authors.lastname: Marres
mesh_terms: D000269:Adhesives; D001915:Braces; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D007825:Laryngectomy / Q000534:rehabilitation*; D007831:Larynx, Artificial; D010780:Photogrammetry / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D011474:Prosthesis Design; D013068:Speech Production Measurement / Q000379:methods; D013071:Speech, Alaryngeal / Q000295:instrumentation*; D014139:Tracheostomy; D016896:Treatment Outcome
chemical_list: D000269:Adhesives