Clinical modification of the tracheostoma breathing valve for voice restoration.

The development of the tracheostoma breathing valve and its use in conjunction with tracheoesophageal (TE) puncture prostheses has offered an important option to laryngectomized patients who undergo surgical-prosthetic voice restoration. Despite advantages that the tracheostoma breathing valve provides, some TE speakers are unable to utilize the device although they are successful users of the TE puncture voice prosthesis. This paper presents a safe, simple, and successful modification of the tracheostoma breathing valve in a single patient who demonstrated anatomical limitations for its use. Modification procedures are presented and clinical implications are discussed.