Recruitment rates too low to continue with the study

Laryngeal dysfunction is a problem that affects many patients after laryngeal cancer therapy (surgery or radio/chemotherapy). Laryngeal dysfunction is associated with higher incidences of aspiration and respiratory tract complications such as aspiration pneumonia. Current standard of care treatment to reduce the consequences of aspiration is often a tracheostomy which has its own risks and complications. The proposed study aims to describe the performance of a new CE marked medical implant, the NewBreez, in protecting the patient's airways from aspiration.

Aspiration is associated with respiratory tract infections, reduced quality of life and increased mortality in patients. For chronic or unresolved aspiration, patients are often given a tracheostomy for safer breathing and greater protection of the airways from aspirated material. However tracheostomies are associated with risks and complications and do not give a 100% guarantee of aspiration protection to the patient. They also impact the quality of life in a negative way for many patients. The current study will evaluate the performance of a new intralaryngeal device for airway protection in a small group of patients who have chronic aspiration. The study will look at the overall performance of this device in preventing aspiration in this specific group of patients as well as determine any unforeseen risks of using this device in the identified group of patients. The outcomes will form the basis of future studies with larger groups of patients.

Inclusion Criteria:

• History of head and neck cancer
• Chronic aspiration
• Currently has a tracheostomy
• Patient is able to independently maintain their tracheostomy and cannula apparatus
• Patient meets the CE Mark indications and are not contraindicated for a NewBreez procedure.
• Anatomically compatible with the available sizes of NewBreez®
• 18 years of age or older
• Sufficient cognitive function to comply with the study and follow-up requirements
• Patient gives voluntary signed informed consent

Exclusion Criteria:

• Recurrent or present cancer in the previous 12 months
• Absent cough reflex
• Severely disrupted swallowing function e.g. severe neurological deficit, absent swallowing reflex, severe fixation of the larynx due to scarring with absent elevation of the larynx
• Upper esophageal sphincter not functional e.g. remains closed
• Cor Pulmonale / Pulmonary Heart Disease, or current lung infection
• Mouth opening less than 3.5cm
• Neck extension severely restricted hindering implantation of the device
• Contraindication to general anesthesia
• Severe hyperostosis (spondylophytes) of the cervical vertebrae causing dysphagia
• Severe (radiogenic) edema or damage of the mucosa of the upper aerodigestive tract

Recruitment of patients will primarily be from the department of Ear, Nose and Throat at the hospitals participating in the study. Secondary recruitment could also include associated clinics that treat patients with laryngeal dysfunction and aspiration, such as swallowing therapy clinics, speech language therapy clinics, and linguistics clinics.

subject 1: 24 hours after receiving the NewBreez implant subject 2: 11 days after receiving the NewBreez implant

Very low recruitment achieved over all sites and early termination of the enrolled subjects gives insufficient data for any meaningful analysis of the product performance and safety in this study.