Tracheoesophageal speakers can achieve speech without digital occlusion by using a tracheostoma valve. Laryngectomized patients who are successful with this device can regain considerable freedom. ...However, little is known about which valve suits the patient best. Valve aerodynamics may give a guideline for its use. Three major tracheostoma valves, each divided into four subtypes, were repeatedly measured in this study. Dynamic pressure and airflow rate signals were sampled through an analog-digital interface into a computer. Considerable aerodynamic differences were observed between the tested valves. The maximum airflow rates, closing pressures, and resistances at low velocities were compared. The presented data may help increase the successful use of tracheostoma valves in tracheoesophageal speakers. Patient factors and additional valve factors should always be taken into account. Further clinical study to validate the clinical relevance of the data is needed.
Abstract: This is a consensus statement on pediatric cochlear implantation by the European Bilateral Pediatric Cochlear Implant Forum. The consensus statement was determined by review of current ...scientific literature to identify areas of scientific and clinical agreement of current understanding of bilateral cochlear implantation. The statement is "Currently we feel that the infant or child with unambiguous cochlear implant candidacy should receive bilateral cochlear implants simultaneously as soon as possible after definitive diagnosis of deafness to permit optimal auditory development; an atraumatic surgical technique designed to preserve cochlear function, minimize cochlear damage, and allow easy, possibly repeated re-implantation is recommended."
In patients with laryngectomy, voice prostheses inserted into a tracheoesophageal fistula (TEF) are widely used for vocal rehabilitation. Gradual dilation of the TEF may cause bothersome leakage ...around voice prostheses. Prosthesis-related weight and mechanical trauma possibly exacerbate TEF dilation. If prosthesis size were to be decreased, with a concomitant decrease in prosthesis weight and diameter, dilation of the TEF would probably lessen. We performed in vitro tests to study the effects on aerodynamic prosthesis function when the prosthesis size-in particular, the inner diameter-was decreased. The effects on airflow and pressure were specifically studied in the airflow range of patients with laryngectomy. A 1-mm decrease of the regular inner prosthesis diameter from 5 mm to 4 mm showed no significant aerodynamic consequences at the average laryngectomized airflow point. Also, such a 1-mm decrease in diameter involved a prosthesis weight reduction of 18%. In view of these findings, downsizing the standard prosthetic diameter should be considered in future voice prosthesis development.
Cochlear implants in children and adolescents Lammers, Marc J W; van der Heijden, Geert J M G; Grolman, Wilko
Archives of pediatrics & adolescent medicine,
2012-Jul-01, Volume:
166, Issue:
7
Journal Article
The availability of an accurate three-dimensional (3-D) model of the tracheostoma and trachea of the laryngectomy patient would be of great help in prototyping of endotracheal prostheses. ...Stereolithography has been described for skull and jaw models but never for soft-tissue reconstructions of the trachea. CT was performed on tracheostomas of 8 patients. The CT data were used to make 3-D models by means of stereolithography. Inverted CT data were used to create air contour models of the same tracheostomas. Eight soft-tissue and 8 air contour models were reconstructed from CT data, showing accuracy and great detail. In this paper we present a previously unreported application of the stereolithography technique. Measurements and prosthesis prototyping, which are impossible to perform on tracheostomas in patients, can now be executed safely. We are using the 3-D tracheostoma models in our research project to develop an endotracheal fixation method for tracheostomal valves.
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