Experience with barton button and peristomal breathing valve attachments for hands-free tracheoesophageal speech

Background. Tracheostoma breathing valves permit hands-free tracheoesophage al (TE) speech production; however, few laryngectomees routinely use them b ecause of problems with attachment. Methods. We retrospectively reviewed the charts of 45 TE speakers to determ ine the success rate and factors associated with successful breathing Valve use based on attachment. AII patients attempted to use a tracheostoma brea thing valve with either a standard or customized peristomal housing, or a s tandard or customized Barton button. Device selection was based on inspecti on of the patient's neck and peristomal contour. Six to eight consecutive h ours of attachment defined success. Results. Overall, 9% of subjects succeeded with any peristomal attachment a s compared to 68% with either a standard (57%) or customized (85%) Barton b utton. Smooth stomal contour, a contiguous stomal lip, and correct button l ength were important for successful Barton button use. Conclusions. Standard or customized Barton buttons offer excellent alternat ives to peristomal housing attachments for hands-free TE speech in select p atients. (C) 2000 John Wiley & Sons, Inc.