Are modern voice prostheses better? A lifetime comparison of 749 voice prostheses

Abstract

The aim of the study was to compare device life of more recent indwelling voice prostheses Provox Vega and Blom-Singer Dual Valve to device life of well-known standard devices (Provox 2, Blom-Singer Classic). In a prospective, non-randomised study, device life of Blom-Singer Classic, Blom-Singer Dual Valve, Provox2, Provox Vega and Provox ActiValve voice prostheses was recorded in a group of 102 laryngectomised patients. In total 749 voice prosthesis were included. Average overall life time was 108 days, median 74 days. The prosthesis with the longest dwell time was the Provox ActiValve (median 291 days). Provox Vega had longer device life compared with Provox2 (median 92 days vs 66 days; p = 0.006) and compared with Blom-Singer Classic (median 92 days vs 69 days; p = 0.004). In conclusion, device lifetimes of Provox Vega and ActiValve were better than those of Provox2 and the Blom-Singer Classic. New voice prostheses, with a defined valve opening pressure (Provox Vega, Provox ActiValve, Blom-Singer Dual Valve) had longer lifetimes than prostheses without a defined opening pressure (Blom-Singer Classic and Provox 2).

Postlaryngectomy prosthetic voice rehabilitation outcomes in a consecutive cohort of 232 patients over a 13‐year period

“…4 The observed median device lifetime of 2 months for the regular VP is noticeably lower than observed in our 19 who observed a median of 74 days (including ActiValve VPs, which figure in our cohort was 70 days). For the regular VPs Provox2 and Vega, this was 63 and 66 days, respectively, and for the problem-solving ActiValve Light and Strong VPs, this was 143 and 186 days, respectively.…”

Long‐term antibiofilm activity of carboxymethyl chitosan on mixed biofilm on silicone

“…Moreover, in some cases, patients suffer from repeated prosthesis failure after few weeks in situ due to biofilm formation and would require durable antibiofilm measures. The use of problem‐solving prostheses, such as the high‐priced Provox Activalve (Atos Medical, Hörby, Sweden) in order to cut health expenses, is in discussion …”

Biofilm on the tracheoesophageal voice prosthesis: considerations for oral decontamination

“…Multifactorial processes related to the esophagus, mouth, and biomaterial of the VP influence biofilm development. Examples are salivary composition, variations in normal microbiota, rough surfaces of silicone VP material, and high humidity that promote biofilm formation and eventual valve failure [8,25]. Microbial plaque deposits on the silicone ultimately lead to leakage and aspiration, and the device must be replaced.…”

“…Indwelling style VPs are worn continuously and exchanged by a clinician when valve functions begin to fail. Average life of these devices is reported between 3–6 months, with a significant variability of several days to several years, based on patient characteristics and device features such as silicone material and valve strength [4–8]. Reasons for device replacement include leakage and various problems with the TEP site, such as enlargement, infection or granulation tissue formation [9].…”