Experimental Assessment and Future Applications of the Shikani Tracheostomy Speaking Valve Purpose Tracheostomy speaking valve use may increase airflow resistance and work of breathing. It remains unclear which valve offers the best performance characteristics. We compared the performance characteristics of the Shikani speaking valve (SSV; unidirectional-flow ball valve) with those of the Passy-Muir valve (PMV; bias-closed flapper valve). Method ... Research Note
Research Note  |   November 2015
Experimental Assessment and Future Applications of the Shikani Tracheostomy Speaking Valve
 
Author Affiliations & Notes
  • Alan H. Shikani
    Maryland Nose and Sinus Center, Baltimore
    The Union Memorial Hospital and Sinai Hospital, Baltimore, MD
  • Andrew C. Miller
    Clinical Center, National Institutes of Health, Bethesda, MD
    West Virginia University, Morgantown
  • Elamin M. Elamin
    James A. Haley Veteran Hospital, Tampa, FL
    University of South Florida, Tampa
  • Disclosure: Alan H. Shikani is the inventor of the ball valve used in this study and derives a royalty from the industry. Andrew C. Miller and Elamin M. Elamin do not have any potential conflicts of interest.
    Disclosure: Alan H. Shikani is the inventor of the ball valve used in this study and derives a royalty from the industry. Andrew C. Miller and Elamin M. Elamin do not have any potential conflicts of interest.×
  • Correspondence to Elamin M. Elamin: eelamin@health.usf.edu
  • Editor: Krista Wilkinson
    Editor: Krista Wilkinson×
  • Associate Editor: Katherine Verdolini Abbott
    Associate Editor: Katherine Verdolini Abbott×
  • Copyright © 2015 American Speech-Language-Hearing Association
Article Information
Swallowing, Dysphagia & Feeding Disorders / Research Notes
Research Note   |   November 2015
Experimental Assessment and Future Applications of the Shikani Tracheostomy Speaking Valve
American Journal of Speech-Language Pathology, November 2015, Vol. 24, 733-738. doi:10.1044/2015_AJSLP-14-0115
History: Received August 18, 2014 , Revised March 3, 2015 , Accepted May 13, 2015
 
American Journal of Speech-Language Pathology, November 2015, Vol. 24, 733-738. doi:10.1044/2015_AJSLP-14-0115
History: Received August 18, 2014; Revised March 3, 2015; Accepted May 13, 2015

Purpose Tracheostomy speaking valve use may increase airflow resistance and work of breathing. It remains unclear which valve offers the best performance characteristics. We compared the performance characteristics of the Shikani speaking valve (SSV; unidirectional-flow ball valve) with those of the Passy-Muir valve (PMV; bias-closed flapper valve).

Method Airflow resistance was measured for both the SSV and the PMV at 8 flow amplitudes and in 3 orientations (−15°, 0°, +20°) in the bias-open and bias-closed configurations.

Results Significantly lower airflow resistance was observed for the SSV (bias open) compared with the PMV at −15° (p < .001), 0° (p < .001), and +20° (p = .006) from the horizon. No significant difference was observed between the PMV and the SSV (bias-closed) configuration at any of the tested angles. A nonsignificant trend toward decreased airflow resistance was observed between the SSV bias-open and bias-closed configurations at each of the angles tested.

Conclusions The SSV demonstrated lower airflow resistance compared with the PMV across 8 flow amplitudes in the bias-open configuration at −15°, 0°, and +20° from the horizon. Further investigation is needed to determine the clinical impact of these findings on patient comfort, work of breathing, phonation, and airway protection during swallowing.

Acknowledgments
The opinions expressed are the view of the authors and do not represent any position or policy of the U.S. National Institutes of Health, the Public Health Service, the Department of Health and Human Services, the Veterans Administration, the State of West Virginia, or the U.S. Government. Elamin M. Elamin received support for travel from SuperDimension.
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