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

doi:10.1002/hed.70046

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 journal › Article › Academic › peer-review

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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 language	English
Pages (from-to)	549-569
Number of pages	21
Journal	Head & neck
Volume	48
Issue number	2
Early online date	8 Oct 2025
DOIs	https://doi.org/10.1002/hed.70046
Publication status	Published - Feb 2026
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 16 Peace, Justice and Strong Institutions

Keywords

Automatic tracheostoma valve
Laryngeal cancer
Tracheoesophageal
Voice prosthesis
Voice quality

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10.1002/hed.70046Licence: CC BY-NC-ND

ArticleFinal published version, 1.01 MBLicence: CC BY-NC-ND

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Dullaart, M. J., de Vreugd, S. R., Leemans, M., van Son, R., Malekzadeh, A., van Alphen, M. J. A., van der Molen, L., van den Brekel, M. W. M., Karssemakers, L. H. E., & Dirven, R. (2026). The Performance of Automatic Speaking Valves and Fixation Devices Enabling Hands-Free Speech Following Total Laryngectomy—A Systematic Review. Head & neck, 48(2), 549-569. https://doi.org/10.1002/hed.70046

@article{071541b0d56c411b8d2eb85f940916bb,

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

abstract = "Background: The percentage of daily automatic speaking valve use (AU) in laryngectomized patients has remained at \textasciitilde{}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.",

keywords = "Automatic tracheostoma valve, Laryngeal cancer, Tracheoesophageal, Voice prosthesis, Voice quality",

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

year = "2026",

month = feb,

doi = "10.1002/hed.70046",

language = "English",

volume = "48",

pages = "549--569",

journal = "Head \& neck",

issn = "1043-3074",

publisher = "Wiley",

number = "2",

}

Dullaart, MJ, de Vreugd, SR, Leemans, M, van Son, R, Malekzadeh, A, van Alphen, MJA, van der Molen, L, van den Brekel, MWM, Karssemakers, LHE & Dirven, R 2026, 'The Performance of Automatic Speaking Valves and Fixation Devices Enabling Hands-Free Speech Following Total Laryngectomy—A Systematic Review', Head & neck, vol. 48, no. 2, pp. 549-569. https://doi.org/10.1002/hed.70046

TY - JOUR

T1 - The Performance of Automatic Speaking Valves and Fixation Devices Enabling Hands-Free Speech Following Total Laryngectomy—A Systematic Review

AU - Dullaart, Max J.

AU - de Vreugd, Sebastiaan R.

AU - Leemans, Maartje

AU - van Son, Rob

AU - Malekzadeh, Arjan

AU - van Alphen, Maarten J.A.

AU - van der Molen, Lisette

AU - van den Brekel, Michiel W.M.

AU - Karssemakers, Luc H.E.

AU - Dirven, Richard

PY - 2026/2

Y1 - 2026/2

N2 - 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.

AB - 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.

KW - Automatic tracheostoma valve

KW - Laryngeal cancer

KW - Tracheoesophageal

KW - Voice prosthesis

KW - Voice quality

UR - https://www.scopus.com/pages/publications/105018526799

U2 - 10.1002/hed.70046

DO - 10.1002/hed.70046

M3 - Article

SN - 1043-3074

VL - 48

SP - 549

EP - 569

JO - Head & neck

JF - Head & neck

IS - 2

ER -

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

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Keywords

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