This program, since 2003 embedded in the program Speech Communication and Phonetic Sciences (Prof. Louis Pols), aims at increasing our understanding of the pathophysiology of oncology related voice and speech disorders, potentially leading to improved rehabilitation and/or intervention strategies. Modern advances in the treatment of head and neck cancer have resulted in improved control rates, although often at the expense of impairment of functions of mouth, throat, and/or voice box. One of these advances is the application of special combined chemotherapy and radiotherapy protocols, which has also resulted in a higher likelihood of preservation of the treated organ. Unfortunately, preservation of an organ does not necessarily mean that its function remains unaffected. Loss of function is even more self-evident in case of surgical procedures, where all or part of an organ has to be removed for cure. Total laryngectomy (complete removal of the voice box) is the mostobvious example of a surgical procedure, that has significant functional side effects, and, besides other consequences, leads to changes in voice and speech. Presently the program focuses on the perceptual and acoustic determinants of speech intelligibility in laryngectomized individuals, who use a special implanted prosthesis for voice rehabilitation. Other oncology related voice and speech disorders as a result of head and neck cancer treatment also are aimed at in this program, which is carried out in close collaboration with the Netherlands Cancer Institute. With the appointment of Prof. Dr. Michiel WM van den Brekel in 2011 as the second ordinarius on the chair for "Oncology-related voice and speech disorders", who is involved in all projects listed below, the continuity of this research program is warranted for many years to come. Currently the following (partly externally-funded) research projects are carried out
Total laryngectomy (TLE) leads to a complete separation of the pharynx (throat) and trachea (wind pipe). This means that the normal way of voicing, using pulmonary air to evoke vibrations of the laryngeal mucosa is no longer possible. The implantation of a so-called voice prosthesis, which re-establishes the connection between the trachea and the pharynx, allows using pulmonary air to evoke vibrations, but now in the pharyngeal mucosa, allowing the patient to speak. The anatomical and functional characteristics of the new sound source that determine the quality of the voice have been studied extensively in recent years. The results of these studies are condensed in the thesis of C.J. van As, PhD (see also the recent literature list below). In the subsequent project we have focused on the perceptual and acoustic determinants of speech intelligibility in laryngectomized individuals. This project was funded by the Breuning-ten Cate Foundation and was carried out in collaboration with Prof. Dr. Ir. Louis Pols (ACLC), Dr. Corina van As-Brooks (Netherlands Cancer Institute), and Dr. Maya van Rossum (formerly Netherlands Cancer Institute, presently Leiden UniversityMedical Center). AIO was Petra Jongmans, MA (thesis "Intelligibility of tracheoesophageal speech; an analytical and rehabilitation study", 2008). This project has provided more insight in the underlying intelligibility problems of TLE speech, such as the problems patients have with voice-voiceless distinction. Specifically addressing these issues in a evidence-based rehabilitation program appeared to significantly improve intelligibility. One of the main problems in further evaluating the effects of specific training, however, is the considerable time consuming nature of the necessary perceptual experiments. Therefore this project is presently continued in collaboration with the University of Gent (Prof.Dr. Jean-Pierre Martens en Dr. Catherine Middag) and the University of Erlangen-Neurenberg (Prof. Dr. Dr. Ultich Eijsholdt), focusing on automatic speech intelligibility analysis (post-doc Dr. Rob van Son, project coordinator; AIO René Clapham, starting August 2010; website ACLC research group: http://www.hum.uva.nl/aclc/ocd.cfm). Funding is based on an unrestricted research grant of Atos Medical, Sweden, the Verwelius Foundation, and a matching grant of the University of Amsterdam.
Total laryngectomy not only affects communication, but inevitably also leads to pulmonary problems. Breathing is possible only through a permanent stoma at the base of the neck, which precludes the normal air-conditioning in the nose. Restoration of lost nose functions (partly) can beachieved by the peri- or intrastomal application of so-called Heat and Moisture Exchangers (HME's). The beneficial influence of these devices on pulmonary problems in laryngectomized individuals is established in several clinical trials, we carried out in the past. Interestingly,in allthese studies significant correlations between pulmonary improvement and improvement in perceived voice quality were found. However, the underlying physiology of HME's was not yet well understood, and the goal of this project, therefore, was to improve our understanding in this respect. This might lead to technical improvements and efficiency of the present generation HME's, not only resulting in a further increase in pulmonary health, but also in better voice quality and thus better quality of life of laryngectomized individuals. This project originally was funded by the Michiel Keijzer Foundation, which is related to the Netherlands Society of Laryngectomees (NSvG). Other funding was received form the Maurits en Anna de Kock Foundation and (as an unrestricted reseach grant) from Atos Medical, Sweden. This project is carried out in close collaboration with Dr. Saar Muller of the Department of Medical Physics of the Netherlands Cancer Institute, the Department of Otolaryngology of the Academic Medical Center (AMC; Prof. Dr. Wytske Fokkens) and the Departments of MTO and Neonatology (Dr. Ir. Frans de Jongh) of the AMC. AIO was J.K. Zuur, MD. The duration of the project was from 2003 to 2007 (Netherlands Cancer Institute projects N04LFV, N04OXY, N05HME). In this project a special Airway Climate Explorer (ACAE) was developed, which now for the first time enables the reliable assessment of the climate (humidity and temperature) in the respiratory tract. Karel Zuur defended his Thesis "Postlaryngectomy pulmonary physiology and tracheal climate and the influence of a heat and moisture exchanger (HME)", based on the development of and first clinical studies with the ACE on April 4, 2008. The projects is still ongoing withanew AIO, Renske Scheenstra (2007-2009), who will expand the clinical ACE studies and assess newly designed HME's. This part of the project is in its final stages and the Thesis defense is expected at the end of 2010. The 3rd AIO on this project is Cindy van den Boer, MD, who currentlyisworkingonthe further evaluation of the patho-physiology of the postlaryngectomy respiratory tract (duration of the project 2009-2013).
Vocal rehabilitation after total laryngectomy with the help of an implanted voice prostheses is presently the gold standard to re-establish oral communication after this (often successful) cancer operation. In the Netherlands, there are currently approximately 2500 laryngectomized individuals. The majority of them are using voice prostheses, which act as one-way valves to allow pulmonary air to be used for voicing and at the same time prevent aspiration of fluids into the trachea. These devices have no 'eternal life' and need to be replaced, when the one-way valve function deteriorates, leading to insufficient closing and thus to aspiration of fluids. Furthermore, deterioration of the valve may also impair voicing. Therefore, current research is focusing on improvement of durability and physical properties of the present generation voice prostheses. This project is funded by an unrestricted research grant by Atos Medical AB, Sweden . This project is carried out in close collaboration with Dr. Annemieke Ackerstaff, Dr. Irene Jacobi, and staff members of the Department of Head and Neck Surgical Oncology of the Netherlands Cancer Institute. Duration since 1987, ongoing (Netherlands Cancer Institute projects N98VOX, N00VOX, M01VOX). The results of Phase I and II trials evaluating the recently developed 3rd generation Provox Vega prostheses have beenpublished/are in press. The main outcome was that the re-designed voice prosthesis shows a significant improvement in voice quality and that the innovative insertion device further eases the replacement of these prostheses. Since the device-life so far has not improved, further projects aiming atthisaspect will be carried out.
Chemoradiation treatment for advanced, inoperable head and neck cancer is increasingly successful in eradicating disease. However, despite the fact that organ preservation is highly likely, function preservation is often still quite poor. The main issues are the development or persistence of trismus and swallowing problems, whereas voicing also can remain impaired. There are indications that early rehabilitation, i.e. starting even before the onset of the therapy can diminish and even prevent some are most of the treatment related problems. Therefore, a prospective, randomized trial is carried out, in which standard speech pathology exercises are compared with a dedicated trismus-treating device, to study the possibilities to prevent post treatment trismus, swallowing, and communication sequels. Funding Atos Medical AB, Sweden (unrestricted research grant). Co-investigators are Dr. Maya van Rossum and Dr. Ludi Smeele. AIO is Lisette van der Molen , MA. Duration 2006-2011 (Netherlands Cancer Institute project N05TSP).
In cancer care, monitoring patients' overall wellbeing and making the right treatment decisions requires good physician-patient communication. Traditionally,however, physician-patient communication tends to limit itself to biomedical concerns; psychosocial concerns are often discussed shortly or not at all. This study evaluates the effect of a screening tool for psychosocial distress during outpatient consultations on prompting discussion between patient and physician. Previous research has shown that screening tools increase the number of issues discussed and physician awareness of these issues. It is unclear, however, whether the screening tool helps physicians and patients to achieve shared views of treatment goals and success - and thus whether it ultimately has an impact on medical decision-making. Taking a conversation-analytic approach, this study focuses on the build-up of shared understanding as physician and patient take turns in speaking. It is known that shared understanding is best achieved through three-turn sequences (with a third confirming or repairing turn), but third turns are traditionally avoided by physicians or used to move on to the next medical question. By analysing video-recorded outpatient consultations, this study will explore whether a discussion prompt will ultimately increase shared understanding of psychosocial concerns. Elin Derks is the PhD student on this project, which is carried out in close collaboration with Prof. Dr. OCM Fischer and Dr. EA Bannink (ACLC), and Prof. Dr. NK Aaronson, NKI.
1. JK Zuur: Postlaryngectomy pulmonary physiology and tracheal climate and the influence of a heat and moisture exchanger (HME). University of Amsterdam, April 4, 2008. 2. P Jongmans: Intelligibility of tracheoesophageal speech; an analytical and rehabilitation study. University of Amsterdam, June 18, 2008. 3. 7. RJ Scheenstra: Influence of Heat and Moisture Exchangers (HMEs) on trachealclimate in laryngectomized individuals; toward optimal pulmonary rehabilitation. University of Amsterdam, February 26,2011. 4. Lisette van der Molen: Preventive rehabilitation in patients treated with chemoradiation for advance head and neck cancer. University of Amsterdam, November 4, 2011.
1. Towards further improvement of pulmonary rehabilitation and respiratory protection of laryngectomized patients with HMEs. C. van den Boer, MD. 2. Automatic analysis of tracheoesophageal speech intelligibility. R. Clapham, MA SLP. 3. Advances in postlaryngectomy voice and speech rehabilitation. Jacqueline Timmermans, MD. 4. Conversation analysis of physician-patient communication. Elin Derks, MA.
1. Honorary Medal of the Dutch Head and Neck Society, Maastricht, October 15, 2010. 2. Honorary Member of the South African Society of Otorhinolaryngology Head and Neck Surgery (Die Suid Afrikaanse Vereniging vir Otorhinolaringologie Kop en Nek Chirurgie), Drankensberg, South Africa, October 26, 2010. 3. Honorary Medal of the Netherlands Society of Otorhinolaryngology and Cervico-Facial Surgery at the 188th Annual Meeting in Nieuwegein, April 7, 2011.
260 publications and 3 edited books (166 papers retrievable through Pubmed (see below and at http://www.ncbi.nlm.nih.gov/pubmed: search 'hilgers f').
1. Soolsma J, van den BrekelMWM, Ackerstaff AH, Balm AJM,Tan IB, Hilgers FJM. Long-term results of Provox ActiValve, solving the problem of frequent Candida- and 'underpressure'-related voice prosthesis replacements. Laryngoscope 2008; 118: 252-257. 2. Hilgers FJM, Soolsma J, van den Brekel MWM, Ackerstaff AH, Balm AJM, Tan IB. A thin tracheal silicone washer solvingperiprosthetic leakage in laryngectomees; direct results and long-term clinical effects. Laryngoscope 2008; 118: 640-645. 3. Zuur JK, Muller SH, Vincent A, Sinaasappel M, de Jongh FHC, Hilgers FJM. Assessment of tracheal temperature and humidity in laryngectomized individuals and the influence of heat and moisture exchangers on tracheal climate. Head Neck 2008; 30: 1072-1082. 4. Dirven R, Hilgers FJM, Plooij JM, Maal TJJ, Bergé SJ, Verkerke GJ, Marres HAM. 3D Stereophotogrammetry for the assessment of tracheostoma anatomy. Acta Otolaryngol. 2008;128: 1248-1254. 5. MA van Rossum, CJ van As-Brooks, FJM Hilgers, M Roozen. Quality of 'glottal' stops in tracheoesophagealspeakers. Clinical Linguistics and Phonetics 2009; 23:1-14. 6. Hilgers FJM. Primary postlaryngectomy vocal, pulmonary and olfactory rehabilitation: an update on the present global state of the art. J Jap Bronchoesophagol Soc 2009; 60: 142-150. 7. VB Wreesmann, LM Smeele, FJM Hilgers, PJFM Lohuis. Closure of tracheoesophageal fistula with prefabricated revascularized bilaminar radial forearm free flap. Head Neck 2009; 31: 838-842. 8. R Scheenstra, SH Muller, A Vincent, M Sinaasappel, JK Zuur, FJM Hilgers. Endotracheal temperature and humidity measurements in laryngectomized patients: intra- and inter-patient variability. Med Biol Eng Comput 2009; 47:773-782. 9. JK Zuur, SH Muller, A Vincent, M Sinaasappel, FHC de Jongh, FJM Hilgers. The influence of a heat and moisture exchanger on tracheal climate in acoldenvironment. Medical Engineering and Physics 2009; 31: 852-857. 10. FJM Hilgers, AH Ackerstaff, M van Rossum, I Jacobi, AJM Balm, IB Tan, MWM van den Brekel. Clinical phase I / feasibility studyofthe next generation indwelling Provox voice prosthesis (Provox Vega). Acta Otolaryngol. 2010; 130: 511-519. 11. P Jongmans, AG Wempe, H van Tinteren, FJM Hilgers, LCW Pols, CJ van As-Brooks. The acoustic analysis of the voiced-voiceless distinction in Dutch tracheoesophageal speech. J Speech Lang Hear Res. 2010; 53: 284-97. 12. HilgersFJM,van den Brekel MWM. Chapter 113: Vocal and Speech Rehabilitation Following Laryngectomy. In: Cummings Otolaryngology: Head and Neck Surgery. 5th Edition. Editors: Flint, Haughey, Richardson, Robbins, Thomas, Niparko, and Lund. Elsevier, Philadelphia; pp 1594-1610. 13. Hilgers FJM, Balm AJM, van den Brekel MWM, Tan IB. Chapter 13. Surgery for larynx and hypopharyngeal cancer; f. Voice restoration. In: Surgery of Larynx and Trachea. Editors: Remacle and Eckel. Springer Verlag, Stuttgart; 2010; pp 245-256. 14. FJM Hilgers, AH Ackerstaff, M van Rossum, I Jacobi, AJM Balm, IB Tan, MWM van den Brekel. Clinical phase I / feasibility study of the next generation indwelling Provox voice prosthesis (Provox Vega). Acta Otolaryngol. 2010; 130: 511-519. 15. Scheenstra RJ, Muller SH, Vincent A, Ackerstaff AH, Jacobi I, Hilgers FJM. Short-term endotracheal climate changes and clinical effects of a heat and moisture exchanger with an integrated electrostatic virus and bacterial filter developed for laryngectomized individuals. Acta Otolaryngol 2010; 130; 739-746. 16. CRN Rasch, M Hauptmann, J Schornagel, O Wijers, J Buter, T Gregor, R Wiggenraad, JP de Boer, AH Ackerstaff, R Kroger, FJP Hoebers, AJM Balm, FJM Hilgers. Intra-arterial versus intravenous chemoradiation for advanced head and neck cancer: results of a randomized phase III trial. Cancer 2010; 116: 2159-2165. 17. FJM Hilgers, AH Ackerstaff, I Jacobi, AJM Balm, IB Tan, MWM van den Brekel. Prospective clinical phase II study of two new indwelling voice prostheses (Provox Vega 22.5 and 20 Fr), and a novel anterograde insertion device (Provox Smart Inserter). Laryngoscope 2010; 120: 1135-1143. 18. R Dirven, PGC Kooijman,TJJMaal, FJM Hilgers, SJ Bergé, HAM Marres. An external neck brace to support the peristomal fixation of an automatic stoma valve (ASV): 3D sterophotogrammetrical assessment. Acta Otolaryngol 2010; 130: 851-858. 19. Scheenstra RJ, Muller SH, Vincent A, Sinaasappel M, Hilgers FJM. The influence of breathing resistance of heat and moisture exchangers on tracheal climate and breathingpattern in laryngectomized individuals. Head Neck 2010; 32: 1069-1078. 20. Karakullukcu B, Lohuis PJ, vd Brekel MW, Hilgers FJM. Sealing of small post-laryngectomy pharyngocutaneous fistulas with voice prosthesis. Laryngoscope 2010; 120: 1971-1973. 21. I Jacobi, L van der Molen, H Huiskens, MA van Rossum, FJM Hilgers Voice and speech outcomes of chemoradiation for advanced head and neck cancer: a systematic review. EAORL. 2010; 267: 1495-1505. 22. van Son RJJH, Jacobi I, Hilgers F. Manipulating Tracheoesophageal Speech. Proceedings Interspeech 2010, Makuhari, Japan, pp. 274-277. 23. Irene Jacobi, Lisette van der Molen, Maya van Rossum, Frans Hilgers. Pre- and Short-term Posttreatment Vocal Functioning in Patients with Advanced Head and Neck Cancer Treated with Concomitant Chemoradiotherapy. Proceedings Interspeech 2010, Makuhari, Japan, pp. 2582-2585. 24. RJ Scheenstra, SH Muller, A Vincent, FJM Hilgers. Heat and moisture exchange capacity of the upper respiratory tract and the effect of tracheotomy breathing on endotracheal climate. Head Neck 2011; 33: 117-124. 25. L Baijens, R Speijer, N Roodenburg, F Hilgers. Prosthetic tracheoesophageal voice production and swallowing function in a patient following circumferential pharyngolaryngectomy and neopharyngeal reconstruction with a jejunal free flap. Dysphagia 2011; 26:78-84. 26. L van der Molen, MA van Rossum, LM Burkhead, LE Smeele, CRN Rasch, Frans JM Hilgers. A randomized preventive rehabilitation trial in advanced head and neck cancer patients treated with chemo-radiotherapy: feasibility, compliance and short-term effects. Dysphagia 2011; 26: 155-170. 27. RJ Scheenstra, SH Muller, FJM Hilgers. Endotracheal temperature and humidity in laryngectomized patients in a warm and dry environment; are heat and moisture exchangers still effective? Head Neck 2011; 33: 1285-1293. 28. RJ Scheenstra, SH Muller, A Vincent, A Ackerstaff, I Jacobi, FJM Hilgers. The effect of a newly developed heat and moisture exchangerforpulmonary rehabilitation of laryngectomized patients on the endotracheal temperature and humidity. Respiratory Care 2011; 56: 604-611. 29. EB van der Houwen, TA van Kalkeren, WJ Post, FJM Hilgers, BFAM van der Laan, GJ Verkerke. Does the patch fit the stoma? A study on peristoma geometry and patch use in laryngectomized patients. Clinical Otolaryngol. 2011; 36: 235-241. 30. van Kalkeren TA, van der Houwen EB, Duits MA, Hilgers FJ, Hebe A, Mostafa BE, Lawson G, Martinez Z, Woisard V, Marioni G, Ruske D, Schultz P, Post WJ, Verkerke BJ, van der Laan BF. A worldwide, multi center study of peristomal geometry and morphology in laryngectomees and its clinical effects. Head Neck. 2011; 33:1184-1190. 31. Jean-Claude Mérol, Anne Charpiot, Thibault Langagne, Patrick Hémar, Annemieke H Ackerstaff, Frans JM Hilgers. Randomized controlled trial on postoperative pulmonary humidification after total laryngectomy: External Humidifier versus Heat and Moisture Exchanger. Laryngoscope, in press. 32. VP Retèl, L van der Molen, Frans JM Hilgers, CRN Rasch, AAMHJ L'Ortye, LMG Steuten, WH van Harten. A cost-effectiveness analysis of a preventive exercise program for patients with advanced head and neck cancer treated with concomitant chemo-radiotherapy. BMC Cancer 2011 Nov 3;11(1):475. 33. AJM Balm, MWM van den Brekel, IB Tan, FJM Hilgers. The indwelling voice prosthesis for speech rehabilitation after total laryngectomy: a safe approach. Otolaryngol Pol.2011; 65: 402-409. 34. J.C. de Bruin-Visser, A.H. Ackerstaff , H. Rehorst, F.J.M. Hilgers. Integration of a smoking cessation program in the treatment protocol for patients with head and neck and lung cancer. Eur Arch ORL. 2012; 269: 659-665. 35. Jean-Claude Mérol, Anne Charpiot , Thibault Langagne, Patrick Hémar, Annemieke H Ackerstaff, Frans JM Hilgers. Randomized controlled trial on postoperative pulmonary humidification after total laryngectomy: External Humidifier versus Heat and Moisture Exchanger. Laryngoscope 2012; 122: 275-281. 36. EAR Theunissen, AJ Timmermans, CL Zuur, O Hamming-Vrieze, JP de Boer, FJM Hilgers, MWM van den Brekel. Total laryngectomy for a dysfunctional larynx after (chemo)radiotherapy. Arch Otolaryngol Head Neck Surg. 2012; 138: 548-555. 37. Annemieke H Ackerstaff, Coen RN Rasch, Alfons JM Balm, Jan Paul de Boer, Ruud Wiggenraad, Derek HF Rietveld, R. Theo Gregor, Robert Kröger, M. Hauptmann, Andrew Vincent, Frans JM Hilgers. Five-years Quality of Life results of the randomized clinical phase III (RADPLAT) trial, comparing concomitant intra-arterial versus intravenous chemoradiotherapy in locally advanced head and neck cancer. Head Neck 2012; 34: 974-980. 38. L van der Molen, MA van Rossum, I Jacobi, RJJH van Son, LE Smeele, CRN Rasch, FJM Hilgers. Pre- and posttreatment voice and speech outcomes in patients with advanced head and neck cancer treated with chemoradiotherapy: expert listeners' and patient's perception. J Voice 2012; 26: 664, e25-33. 39. FJM Hilgers, R Dirven, Y Wouters, I Jacobi, HAM Marres, MWM van den Brekel. A multicenter prospective clinical trial evaluating a novel adhesive baseplate (Provox StabiliBase) for enhanced peristomal attachment of postlaryngectomy pulmonary and voice rehabilitation devices. Laryngoscope 2012; 122: 2447-2453. 40. FJM Hilgers, KJ Lorenz, H Maier, CA Meeuwis, JDF Kerrebijn,V Vander Poorten, A-S Vinck, M Quer, MWM van den Brekel. Development and (pre-) clinical assessment of a novel surgical tool for primary and secondary tracheoesophageal puncture with immediate voice prosthesis insertion, the Provox Vega Puncture Set. Eur Arch ORL. online March 3, 2012.
1. MA vanRossum, PJongmans, CJ van As-Brooks, FJM Hilgers. De ontwikkeling van een evidence-based therapieprogramma voor het verbeteren van spraakverstaanbaarheid bij tracheoesofageale sprekers. (The development of an evidence-based therapy program for the improvement of intelligibility in tracheoesophageal speakers). Stem-, Spraak-, en Taalpathologie 2008; 16: 112-123. 2. MA van Rossum, P Jongmans, CJ van As-Brooks, FJM Hilgers. Spraakverstaanbaarheid bij tracheoesophageal sprekers; een therapieprogramma voor het verbeteren van spraakverstaanbaarheid. Logopedie en Foniatrie 2009; 5: 172-176. 3. I Jacobi, AH Ackerstaff, MA van Rossum, FJM Hilgers. Acoustic evaluation and speaker-subjective perception of tracheoesophageal voicing. Proceedings of the AVFA 3rd Advanced VoiceFunction International Workshop, Madrid, Spain, May 18-20, 2009; pp. 77-80. 4. R.P. Clapham, F.J.M. Hilgers, M.W.M. van den Brekel, R.J.J.H. van Son. An Exploration into Automatic Phonological Feature Evaluation of Tracheoesophageal Speech. In: Sounds and Sounds; eds. W Zonneveld, H Quené, and W Heeren. Publisher UiL OTS, Utrecht; December 2011; pp. 69-79. BSAB: 01111946. 5. AJ Timmermans, M Krap, FJM Hilgers, MWM van den Brekel. Spraakrevalidatie na totale laryngectomie. (Speech rehabilitation after total laryngectomy.) Ned Tijdschr Tandheelk. 2012; 119: 357-361. 6. van den Brekel MWM, Hilgers FJM. Preoperative workupof the neckin head and neck squamous cell carcinoma. In: Pearls and Pitfalls in Head and Neck Surgery; practical tips to minimize complications; second revised and extended edition. Editor Cernea CR; associate editors: Dias FL, Fliss D, Lima RA, Myers EN, Wei WI. Karger Publishers, Basel, Freiburg, Paris, London, New York, Bangalore, Bangkok, Shanghai, Singapore, Tokyo, Sydney; 2012, pp.36-37. ISBN 978-3-8055-9972-6. 7. Hilgers FJM, van den Brekel MWM. Practical tips for voice rehabilitation after pharyngolaryngectomy. In: Pearls and Pitfalls in Head and Neck Surgery; practical tips to minimize complications; second revised and extended edition. Editor Cernea CR; associate editors: Dias FL, Fliss D, Lima RA, Myers EN, Wei WI. Karger Publishers, Basel, Freiburg, Paris, London, New York, Bangalore, Bangkok, Shanghai, Singapore, Tokyo, Sydney; 2012, pp 94-95. ISBN 978-3-8055-9972-6. 8. K J Lorenz, FJM Hilgers, H. Maier. A novel puncture instrument: the Provox-Vega® puncture set: Its use in voice prosthesis insertion following laryngectomy. HNO. 2012, online July 7. 9. AJ Timmermans, MWM van den Brekel, L van der Molen, A Navran, ThF Nijssen, FJM Hilgers. Nieuwe ontwikkelingen op het gebied van zorg en nazorg van hoofd-halskanker . ( New developments in the treatment and rehabilitation of head and neck cancer in the Netherlands). Ned Tijdschr Geneeskd. 2012; 156: 1791-1724 (A5059). 10. RP Clapham, L van der Molen, RJJH van Son, M van den Brekel, FJM Hilgers. NKI-CCRT Corpus - Speech Intelligibility Before and After Advanced Head and Neck Cancer Treated with Concomitant Chemoradiotherapy. In: Proceedings of the Eight International Conference on Language Resources and Evaluation. May 23-25, 2012, Istanbul, Turkey; editorsNicolettaCalzolari, Khalid Choukri, Thierry Declerck, Mehmet Uğur Doğan, Bente Maegaard, Joseph Mariani, Jan Odijk, and Stelios Piperidis. Publisher: European Language Resources Association (ELRA): ISBN 978-2-9517408-7-7; pp 3350-3355. 11. Frans JM Hilgers, Renske J Scheenstra, Sara H Muller. Michiel WM van den Brekel. Aktuelle Forschung zur Verbesserung der Wärme und Feuchtigkeitskapazität von HME for Laryngektomierte patienten. In: Pulmonale Rehabilitation nach Laryngektomie. Eds. Kai Lorenz. Unimed Verlag, Bremen. In press. 12. Frans JM Hilgers, Annemieke H Ackerstaff, Michiel WM van den Brekel. Bedeutung von HME für die ganzheitliche Rehabilitation nach LE. In: Pulmonale Rehabilitation nach Laryngektomie. Eds. Kai Lorenz. Unimed Verlag, Bremen. In press.
Department of Head and Neck Oncology and Surgery
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital
Department of Otolaryngology
Academic Medical Center
University of Amsterdam