Improving the quality of life for larynx cancer patients
Currently, voice rehabilitation of larynx cancer patients is performed by inserting a one-way shunt valve between trachea and oesophagus that prevents food and liquid from entering the trachea. Pressing the tracheal opening with a finger forces exhaled air through the shunt valve to the oesophagus, where soft tissue structures serve as a substitute voice. However, the voice is in many cases of poor quality and the process creates a mental barrier during speaking, as patients have to literally point at their handicap.
The NEWVOICE project aims to improve the quality of life for laryngectomees by developing a new voice-producing shunt prosthesis that is able to produce a voice with sufficient loudness, adjustable fundamental frequency and natural intonation.
Dr. Bart Verkerke, Project Manager of the Department of BioMedical Engineering at the main partner, the University of Groningen, describes how the partners initiated this work in a previous EUREKA project. “Most of the NEWVOICE participants were involved in project E! 723 ARTIFICIAL LARYNX, during which we gained a lot of the expertise in medical devices to improve the rehabilitation process that will be used in this project.”
The new voice-producing element that was inspired by the lips of a trumpet player is working well technically, but poses a prototyping problem as it is too big to fit into an existing shunt valve. Work is progressing to try to develop a small voice-producing element that still has the proper frequency characteristics. At the same time, the project also aims to develop a new fixation technique, the so-called tissue connector, which allows for a larger shunt valve.
Six different concepts for the tissue connector that fastens the shunt valve in place are being tested as “it was impossible to determine which of the alternatives was the most appropriate. We will perform a pilot animal study to test them and choose the most effective,” says Verkerke.
A critical problem facing the project team is that food and fluid passing the shunt valve stimulates the formation of a biofilm. “This causes the shunt valve to malfunction, making it necessary to replace the shunt valve frequently, on average every four months,” explains Dr Mark Waters, Senior Lecturer in Biomaterials at Cardiff Dental School. “The task of the UK partners is to develop silicone rubber materials which are less susceptible to biofilm formation.”
The project has already developed coatings that slow down or prevent biofilm adhesion that could extend the life of a shunt valve for some patients considerably.
According to Verkerke, “the major challenges lying ahead include finding a material that can resist all yeasts and bacteria, proving that the concept of the tissue connector works, and finding a voice-producing element small enough to fit into a shunt valve.”
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