Tracheostoma valve for postlaryngectomy voice rehabilitation.

Newer surgical techniques for postlaryngectomy voice rehabilitation provide a simple, effective method of communication but require manual occlusion of the tracheostoma during speech. We report the development of a unique tracheostoma valve that avoids the necessity for covering the stoma. This airflow-sensitive valve closes during speech and remains open with normal respiration. Results of a clinical trial with 50 patients over a ten-month period are encouraging. Our experience suggests that excessive vocal tract resistance to airflow is the principal limitation to effective valve use. Approaches to decreasing airflow resistance through the vocal tract to improve both voice production and tracheostoma valve use are discussed.