Abstract
People who have undergone total laryngectomy typically have difficulties speaking and coughing. Coughing, the protective reflex action where air is rapidly expelled from the lungs to clear the airway, is crucial in everyday life. Insufficiency in coughing can lead to serious chest infections. In this research we present a bionic assistive coughing device (RoboCough) to improve coughing efficacy among laryngectomy patients by increasing pressure and flow rate. RoboCough was designed to mimic the function of the glottis and trachea in the upper respiratory system. Experimental results show a significant increase (t(64) = 4.9, p < 0.0001) in peak cough flow rate and peak cough pressure (t(64) = 12.6, p < 0.0001) among 33 control participants using RoboCough. A pilot study with a smaller cohort of laryngectomy patients shows improvement in peak cough pressure (p = 0.0159) using RoboCough. Preliminary results also show that post-laryngectomy coughs achieved similar peak cough flow (Z = -0.9933, p = 0.32) to the control group’s natural cough. Coughing capabilities could be improved through using RoboCough. Applications of RoboCough include simulation of vocal folds and respiratory conditions, rehabilitation of ineffective coughs from laryngeal and respiratory diseases and as a test-bed for the development of medical devices for respiratory support.
Highlights
C ANCER Research UK statistics reported around 11,900 new cases of head and neck cancers yearly between 2014-2016 [1]
Increased coughing efficiency is indicated by either an increased gastric pressure or an increased Peak Cough Flow rate (PCF), which can be achieved by increasing the expiratory muscle strength or by increasing the pressure resistance of the vocal folds.In this study we focus primarily on the function of the vocal fold area and expiratory pressure
It can be seen from the graphs that when comparing voluntary and RoboCough coughs, RoboCough generates a higher peak flow rate and a higher peak cough pressure, and takes a longer time to return to baseline
Summary
C ANCER Research UK statistics reported around 11,900 new cases of head and neck cancers yearly between 2014-2016 [1]. Treatments of laryngeal cancer varies depending on the pathology. Total laryngectomy is indicated for the curative treatment of laryngeal cancer where the tumour is considered to be too advanced for radiotherapy or partial resection. Speech and coughing problems are significantly higher among patients with total laryngectomy compared to partial laryngectomy patients [2]. Total laryngectomy is a procedure that involves the removal of the entire larynx and the upper tracheal cartilage rings [3]. Post laryngecotomy patients are no longer at the risk of aspiration pneumonia, some patients have difficulties
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