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Published on: May 18, 2019
Experience with Barton button and peristomal breathing valve attachments for hands-free tracheoesophageal speech
J S Lewin1, J Lemon, J K Bishop-Leone
1Department of Head and Neck Surgery, The University of Texas, M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 69, Houston, Texas 77030, USA. jlewin@mdanderson.org
Background:
Tracheostoma breathing valves permit hands-free tracheoesophageal (TE) speech production; however, few laryngectomees routinely use them because of problems with attachment.
Methods:
We retrospectively reviewed the charts of 45 TE speakers to determine the success rate and factors associated with successful breathing valve use based on attachment. All patients attempted to use a tracheostoma breathing valve with either a standard or customized peristomal housing, or a standard or customized Barton button. Device selection was based on inspection of the patient's neck and peristomal contour. Six to eight consecutive hours of attachment defined success.
Results:
Overall, 9% of subjects succeeded with any peristomal attachment as compared to 68% with either a standard (57%) or customized (85%) Barton button. Smooth stomal contour, a contiguous stomal lip, and correct button length were important for successful Barton button use.
Conclusions:
Standard or customized Barton buttons offer excellent alternatives to peristomal housing attachments for hands-free TE speech in select patients.
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