Patient-specific tracheal stoma plug improves quality of life for tracheostomy patients

Abstract

Objective Despite being life-saving, tracheostomies carry numerous social, functional and quality of life (QOL) drawbacks. The aim of this study was to design and test the use of small, discrete, customised tracheostomy stoma plugs in patients who are not tracheostomy-dependent during the day, with the overall goals to demonstrate the feasibility of creating these patient-specific devices and obtain preliminary results of impact on QOL. Methods We developed and evaluated a novel patient-specific ‘stoma plug’ to improve the lives of those with tracheostomies who did not have a daytime ventilation requirement. The stoma plug was designed and manufactured using three-dimensional printing for each subject. Measurements of the patient’s fistula were obtained in the clinic and the features of the stoma plug were created to match the fistula and trach tube dimensions. Patients were monitored for any changes in their eligibility status and for complications associated with using the ‘stoma plug’. A survey questionnaire examining multiple QOL domains was performed predevice and at 1 and 6 months of use. Results Devices were designed and produced for 35 patients enrolled across two institutions. The survey results demonstrate statistically significant improvement in quality-of-life scores (p<0.05) in all six domains queried (Overall QOL, voice strength, voice clarity, water tolerance, swallowing and breathing) with substantial improvements in social isolation and skin irritation reported. Conclusion Our study demonstrates that a patient specific device can be created to ameliorate many of the drawbacks associated with a tracheostomy tube, with the potential to revolutionise tracheostomy care.