Difference between revisions of "Speech prostheses"

From HCE Wiki - The Human Cognitive Enhancement Wiki
Jump to: navigation, search
(updated)
(added pictures)
Line 1: Line 1:
 +
[[File:Voice prosthesis wikimedia.jpg|thumbnail|right|Demonstration about how speech is generated while using a one-way valve with the finger covering the stoma.]]
 
Speech prostheses, or voice prostheses, is a overall term for small, silicon one-way valves that are inserted into the tracheo-oesophageal puncture of laryngectomy patients. The prosthesis not only safely divides the oesophagus and trachea, but also allow speech when the outside of the tracheostoma, the opening on the neck to allow air in, is covered with a finger or otherwise occluded. This is greatly beneficial to patients because it allows to communicate without the need to use either an [[Electrolarynx]] or [[Speech synthesizers]].
 
Speech prostheses, or voice prostheses, is a overall term for small, silicon one-way valves that are inserted into the tracheo-oesophageal puncture of laryngectomy patients. The prosthesis not only safely divides the oesophagus and trachea, but also allow speech when the outside of the tracheostoma, the opening on the neck to allow air in, is covered with a finger or otherwise occluded. This is greatly beneficial to patients because it allows to communicate without the need to use either an [[Electrolarynx]] or [[Speech synthesizers]].
  
Line 4: Line 5:
  
 
Oesophageal valves are made of medical grade silicon rubber and primarily consists of four parts: One-way valve, two flanges on each side of the tube, rigid valve ring in the middle of the tube, and a safety strap that is either removed after the insertion, or left on the device depending on whether it is in-dwelling or patient-changeable. The two flanges are tracheal flange and esophageal flange respectively. They vary in rigidity and size. Both depend on the valve being patient-changeable or not, with the latter being bigger in size and rigid so as to facilitate bigger longevity. The overall size, especially the diameter of the tube depends on patient's preference and the size of the tracheo-oesophageal puncture.
 
Oesophageal valves are made of medical grade silicon rubber and primarily consists of four parts: One-way valve, two flanges on each side of the tube, rigid valve ring in the middle of the tube, and a safety strap that is either removed after the insertion, or left on the device depending on whether it is in-dwelling or patient-changeable. The two flanges are tracheal flange and esophageal flange respectively. They vary in rigidity and size. Both depend on the valve being patient-changeable or not, with the latter being bigger in size and rigid so as to facilitate bigger longevity. The overall size, especially the diameter of the tube depends on patient's preference and the size of the tracheo-oesophageal puncture.
 
+
[[File:Prosthesis inserter.jpg|thumbnail|right|Valve attached on a inserter. The safety strap is usually cut off after the insertion.]]
 
Usage of a valve for voice restoration was first described by a Polish otolaryngologist prof. dr. Erwin Mozolewski in the 1970s.<ref>Mozolewski, Erwin S., et al. "Arytenoid vocal shunt in laryngectomized patients." The Laryngoscope 85.5 (1975): 853-861.</ref> First commercially available oesophageal valve was introduced in the late 1970s, which was introduced by Eric Blom and Mark Singer and was considered a major step in voice restoration. Up to the introduction of this procedure, laryngectomy patients were required to learn oesophageal speech or use an electrolarynx to be able to communicate again.<ref name="kazi07">KAZI, Rehan, et al. Surgical voice restoration following total laryngectomy. Journal of cancer research and therapeutics, 2007, 3.4: 188. Available online at: http://medind.nic.in/jat/t07/i4/jatt07i4p188.htm (Retrieved 24 February 2016)</ref> In 1985, inserting oesophageal valves has been accepted as a primary procedure in the US.<ref>HAMAKER, Ronald C., et al. Primary voice restoration at laryngectomy. Archives of Otolaryngology, 1985, 111.3: 182-186.</ref> Since then, the procedure became the de facto standard for post-laryngectomy treatment and voice restoration.<ref>HUTCHESON, Katherine A., et al. Enlarged tracheoesophageal puncture after total laryngectomy: A systematic review and meta‐analysis. Head & neck, 2011, 33.1: 20-30.</ref>
 
Usage of a valve for voice restoration was first described by a Polish otolaryngologist prof. dr. Erwin Mozolewski in the 1970s.<ref>Mozolewski, Erwin S., et al. "Arytenoid vocal shunt in laryngectomized patients." The Laryngoscope 85.5 (1975): 853-861.</ref> First commercially available oesophageal valve was introduced in the late 1970s, which was introduced by Eric Blom and Mark Singer and was considered a major step in voice restoration. Up to the introduction of this procedure, laryngectomy patients were required to learn oesophageal speech or use an electrolarynx to be able to communicate again.<ref name="kazi07">KAZI, Rehan, et al. Surgical voice restoration following total laryngectomy. Journal of cancer research and therapeutics, 2007, 3.4: 188. Available online at: http://medind.nic.in/jat/t07/i4/jatt07i4p188.htm (Retrieved 24 February 2016)</ref> In 1985, inserting oesophageal valves has been accepted as a primary procedure in the US.<ref>HAMAKER, Ronald C., et al. Primary voice restoration at laryngectomy. Archives of Otolaryngology, 1985, 111.3: 182-186.</ref> Since then, the procedure became the de facto standard for post-laryngectomy treatment and voice restoration.<ref>HUTCHESON, Katherine A., et al. Enlarged tracheoesophageal puncture after total laryngectomy: A systematic review and meta‐analysis. Head & neck, 2011, 33.1: 20-30.</ref>
  

Revision as of 14:41, 25 February 2016

Demonstration about how speech is generated while using a one-way valve with the finger covering the stoma.

Speech prostheses, or voice prostheses, is a overall term for small, silicon one-way valves that are inserted into the tracheo-oesophageal puncture of laryngectomy patients. The prosthesis not only safely divides the oesophagus and trachea, but also allow speech when the outside of the tracheostoma, the opening on the neck to allow air in, is covered with a finger or otherwise occluded. This is greatly beneficial to patients because it allows to communicate without the need to use either an Electrolarynx or Speech synthesizers.

Main characteristics

Oesophageal valves are made of medical grade silicon rubber and primarily consists of four parts: One-way valve, two flanges on each side of the tube, rigid valve ring in the middle of the tube, and a safety strap that is either removed after the insertion, or left on the device depending on whether it is in-dwelling or patient-changeable. The two flanges are tracheal flange and esophageal flange respectively. They vary in rigidity and size. Both depend on the valve being patient-changeable or not, with the latter being bigger in size and rigid so as to facilitate bigger longevity. The overall size, especially the diameter of the tube depends on patient's preference and the size of the tracheo-oesophageal puncture.

Valve attached on a inserter. The safety strap is usually cut off after the insertion.

Usage of a valve for voice restoration was first described by a Polish otolaryngologist prof. dr. Erwin Mozolewski in the 1970s.[1] First commercially available oesophageal valve was introduced in the late 1970s, which was introduced by Eric Blom and Mark Singer and was considered a major step in voice restoration. Up to the introduction of this procedure, laryngectomy patients were required to learn oesophageal speech or use an electrolarynx to be able to communicate again.[2] In 1985, inserting oesophageal valves has been accepted as a primary procedure in the US.[3] Since then, the procedure became the de facto standard for post-laryngectomy treatment and voice restoration.[4]

Purpose

The purpose of speech prostheses is to return the ability to speak to patients after total laryngectomy.

Important Dates

1873 - Austrian surgeon Theodore Billroth performs the first laryngectomy.[5]

1972 - Polish-born otolaryngologist prof. dr. Erwin Mozolewski develops a way to give back voice abilities to laryngectomy patients with a small plastic valve connecting their larynx and oesophagus. The valve was officially unveiled on a international conference in Boston in 1979.[6]

1980s - The technique was popularized and made commercially available by an American company Bloom-Singer.[7]

Enhancement/Therapy/Treatment

Treatment - Speech prostheses aim to restore the ability to speak and bring the patient's quality of life as close as possible to the state before the laryngectomy.

Ethical & Health Issues

Ethical - "hole in the neck", accessories to cover it (turtle-necks etc.)

Health - leakage, sanitation, valves need replacement, heat & moisture (https://en.wikipedia.org/wiki/Heat_and_moisture_exchanger_after_laryngectomy), https://en.wikipedia.org/wiki/Esophageal_speech

Public & Media Impact and Presentation

TODO: Cancer support groups and websites.

Public Policy

Related Technologies, Projects or Scientific Research

TODO: Add list and pictures of specific valves.

https://www.inhealth.com/category_s/44.htm

http://www.cancerresearchuk.org/about-cancer/type/larynx-cancer/living/stoma/starting-out-with-a-breathing-stoma

http://www.webwhispers.org/library/tepprosthesis.asp

https://en.wikipedia.org/wiki/Voice_prosthesis

http://medind.nic.in/jat/t07/i4/jatt07i4p188.htm

References

  1. Mozolewski, Erwin S., et al. "Arytenoid vocal shunt in laryngectomized patients." The Laryngoscope 85.5 (1975): 853-861.
  2. KAZI, Rehan, et al. Surgical voice restoration following total laryngectomy. Journal of cancer research and therapeutics, 2007, 3.4: 188. Available online at: http://medind.nic.in/jat/t07/i4/jatt07i4p188.htm (Retrieved 24 February 2016)
  3. HAMAKER, Ronald C., et al. Primary voice restoration at laryngectomy. Archives of Otolaryngology, 1985, 111.3: 182-186.
  4. HUTCHESON, Katherine A., et al. Enlarged tracheoesophageal puncture after total laryngectomy: A systematic review and meta‐analysis. Head & neck, 2011, 33.1: 20-30.
  5. KAZI, R. A., et al. Christian Albert Theodor Billroth: Master of surgery. Journal of postgraduate medicine, 2004, 50.1: 82. Available online at: https://tspace.library.utoronto.ca/bitstream/1807/2074/1/jp04025.pdf (Retrieved 25 February)
  6. http://www.mp.pl/kurier/51663
  7. http://www.inhealth.com/v/vspfiles/pdf/brochures/Blom-Singer_Historic_Achievements_Brochure.pdf