A new custom moldable external neck brace (ENB 2.0) to improve hands-free speech in laryngectomized patients

Laryngoscope. 2013 Sep;123(9):2209-15. doi: 10.1002/lary.24044. Epub 2013 Mar 11.

Abstract

Objectives/hypothesis: The majority of laryngectomy patients fail to use a hands-free valve on a daily basis, mainly due to fixation problems of the adhesive baseplate housing. To support adhesive housings during hands-free speech a new external neck brace (ENB 2.0) was developed. The effect of the brace was assessed in terms of a qualitative assessment, adhesive lifetime, maximum phonation time and patient self-reports.

Study design: Twenty laryngectomees participated in this randomized, prospective, crossover trial.

Methods: All participants used the Provox hands-free HME valve with an Xtrabase adhesive for 1 month, 2 weeks with an ENB 2.0, and 2 weeks without. Outcomes were compared with the previous model of the external neck brace (ENB 1.0).

Results: The average total number of adhesive baseplates used during the trial was 16.7 in the non-brace group versus 10.9 in the brace group (P = 0.05). The number of daily replacements was 1.4 in the non-brace group and 1.1 in the brace group (P = 0.025). The average time a hands-free valve was worn per baseplate was 9.5 hours when wearing a neck brace versus 7.3 hours without brace (P = 0.09).The majority (81%) of the patients considered the neck brace 2.0 as a welcome addition to improve hands-free speech after laryngectomy and would use it if prescribed (88%).

Conclusion: The new model of the neck brace reduces the number of baseplate replacements during hands-free speech and is considered as a helpful device by 81% of the participants.

Keywords: External neck brace; adhesive lifetime; custom moldable; hands-free speech; hands-free valve; total laryngectomy; tracheoesophageal speech.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Braces*
  • Cross-Over Studies
  • Equipment Design
  • Equipment Safety
  • Female
  • Humans
  • Laryngeal Neoplasms / surgery
  • Laryngectomy / methods
  • Larynx, Artificial*
  • Linear Models
  • Male
  • Middle Aged
  • Neck*
  • Patient Satisfaction / statistics & numerical data
  • Pliability
  • Prospective Studies
  • Quality of Life*
  • Speech, Alaryngeal / instrumentation*
  • Statistics, Nonparametric
  • Tissue Adhesives
  • Treatment Outcome

Substances

  • Tissue Adhesives