title: Clinical use of a neck brace to improve hands-free speech in laryngectomized patients.
abstract: OBJECTIVE
  Time of adherence of adhesive baseplate housings to the neck of a laryngectomized patient is one of the main problems that account for the low number of laryngectomy patients who benefit from hands-free speech. An external neck brace (ENB 1.0) was introduced to support peristomal fixation of adhesive baseplates.
  
  
  METHODS
  A prospective randomized controlled clinical cross-over trial.
  
  
  METHODS
  A total of 28 laryngectomy patients participated in this randomized, prospective, crossover trial. All used the Provox hands-free heat and moisture exchanger (HME) valve for 1 month: 2 weeks with an ENB and 2 weeks without.
  
  
  RESULTS
  The median lifetime of an adhesive baseplate without a brace was 52.5 minutes versus 210 minutes with a brace (P = .03). Four participants considered the ENB as "a little" bit of a welcome addition, nine as "quite a bit," and six as "very much" (79%) to improve hands-free speech.
  
  
  CONCLUSIONS
  The ENB significantly increases the lifetime of an adhesive baseplate and therefore contributes to achieving hands-free speech for a greater number of patients with laryngectomy.
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, Radboud University Nijmegen Medical Centre, The Netherlands. r.dirven@kno.umcn.nl
authors.forename: Richard
authors.initials: R
authors.lastname: Dirven
authors.forename: Piet G C
authors.initials: PG
authors.lastname: Kooijman
authors.forename: Yannick
authors.initials: Y
authors.lastname: Wouters
authors.forename: Henri A M
authors.initials: HA
authors.lastname: Marres
mesh_terms: D000328:Adult; D000368:Aged; D001915:Braces; D016001:Confidence Intervals; D018592:Cross-Over Studies; D005260:Female; D005500:Follow-Up Studies; D006225:Hand; D006801:Humans; D007822:Laryngeal Neoplasms / Q000534:rehabilitation / Q000601:surgery; D007825:Laryngectomy / Q000379:methods / Q000534:rehabilitation*; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D009333:Neck; D009426:Netherlands; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011788:Quality of Life; D018570:Risk Assessment; D013068:Speech Production Measurement; D013071:Speech, Alaryngeal / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome