The Performance of Automatic Speaking Valves and Fixation Devices Enabling Hands-Free Speech Following Total Laryngectomy—A Systematic Review

Max J. Dullaart, Sebastiaan R. de Vreugd, Maartje Leemans, Rob van Son, Arjan Malekzadeh, Maarten J.A. van Alphen, Lisette van der Molen, Michiel W.M. van den Brekel*, Luc H.E. Karssemakers, Richard Dirven

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: The percentage of daily automatic speaking valve use (AU) in laryngectomized patients has remained at ~25% since their invention. To increase this percentage, understanding the performance of existent devices is essential. Therefore, we reviewed studies reporting AU, fixation device lifetime (FDL), compliance, and voice and speech assessment outcomes (VSAOs).

Methods: Studies published until 23 April 2025 were included. Quality assessment was performed using RoB2, ROBINS-I, and JBI tools.

Results: Twenty studies were included, which were of poor methodological quality. AU and FDL were 3–13.25 h/day and 0.17–24 h/day. Baseline daily ASV compliance rate was 25%, increasing short-term but decreasing long-term. Reasons for non-compliance were inadequate fixation, skin problems, and voicing being too tiresome. There were no significant differences across ASVs in VSAOs.

Conclusion: No single ASV or fixation device outperformed others. Personalized approaches, tailored to ASV experience, tracheostoma anatomy, and patient needs, may increase AU, FDL, and long-term compliance.

Original languageEnglish
Pages (from-to)549-569
Number of pages21
JournalHead and Neck
Volume48
Issue number2
Early online date8 Oct 2025
DOIs
Publication statusPublished - Feb 2026

Bibliographical note

Publisher Copyright:
© 2025 The Author(s). Head & Neck published by Wiley Periodicals LLC.

Keywords

  • automatic Tracheostoma valve
  • laryngeal cancer
  • tracheoesophageal
  • voice prosthesis
  • voice quality

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