For Professionals UltraVoice Case Study




UltraVoice has been used successfully to enable patients on ventilators to speak, especially in cases where the Passy-Muir valve has failed. Although the Passy-Muir is the first option to try, it is not always successful for a variety of reasons. Some of the reasons for failure would be too much saliva and secretions leading to valve clogging, problems with a person’s anatomy which would prevent the Passy-Muir valve from fitting properly and so forth.

Patients may be on a ventilator due to ALS or Lou Gehrig’s disease, post polio syndrome, head or neck injury, chronic obstructive pulmonary diseases (asthma, bronchitis, emphysema, etc.), obstructive sleep apnea, congestive heart failure, neuromuscular paralysis, etc.

What follows below is the account of a speech pathologist who was trying to assist a postpolio patient on a ventilator to speak after his Passy-Muir had failed.

Trying to find an effective means for my ventilator-dependent postpolio patient, S.K., to communicate independently was a big challenge, but I finally found the UltraVoice, an intraoral artificial larynx originally developed for laryngectomy patients. S.K. had recovered from childhood paralytic poliomyelitis with mild right facial weakness, and had Postpolio Syndrome with progressive paralysis. He was quadraplegic and ventilator-dependent. Except for the facial weakness, his speech musculature was intact. He was referred to me after attempts with independent communication systems failed.

LIMITED OPTIONS

As a former RRT with much ventilator experience, I knew most of S.K.'s options. His ENT doctor had tried a conventional ventilator speaking valve but, because of apparent anatomical difficulties and copious pulmonary and oral secretions, it didn't work. So, I decided against a speaking valve. I also felt his family might have problems with possible volume changes each time his cuff was deflated and the valve was placed.

Someone had lent S.K. an electrolarynx, but it didn't give him the independence he desired. He was upset that conversation partners had to place the electrolarynx on his neck. He tried a hands-free electrolarynx with a headset and latching switch, but had problems using the mouth tube. Again, he felt dependent, and was hard to understand.

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