Factors influencing the longevity and replacement frequency of Provox voice prostheses

Abstract

INTRODUCTIONThis study aimed to assess the factors that influence the longevity and replacement frequency of Provox voice prostheses following their placement. METHODSThe medical records of 27 patients who received Provox voice prostheses after total laryngectomy and attended follow-up regularly between 1998 and 2012 were retrospectively reviewed. The success rate of the Provox voice prostheses (i.e. whether speech was achieved), quality of speech achieved, number and type of complications encountered, frequency of prostheses replacement and reasons for prostheses replacements were evaluated.RESULTS All 27 patients were men and their mean age was 63.0 (range 43-78) years. The mean follow-up period was 60.3 (range 1-168) months. Fluent and understandable speech was achieved in 85.0% of the patients. The mean duration before prosthesis replacement had to be performed was 17.1 (range 1-36) months. The most frequent complication was fluid leakage through the prosthesis. There was a strong positive correlation of 77.1% between the longevity of prostheses and postoperative follow-up duration (r = 0.771; p < 0.01). CONCLUSIONThe voice prosthesis is a tool that can be delivered in a practical fashion and replaced easily with no serious complications. It is a means by which speech can be restored, with a high success rate, after total laryngectomy. In the present study, we found that postoperative follow-up duration was the most important factor influencing the longevity of the Provox voice prosthesis.

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

“…26 An explanation might be the financial challenges prosthetic voice rehabilitation imposes on patients. 26 An explanation might be the financial challenges prosthetic voice rehabilitation imposes on patients.…”

“…Contrary to the decreasing device lifetime observed in our cohort and in other western countries, some studies from low-income countries report device lifetimes of up to 17-months average. 26 An explanation might be the financial challenges prosthetic voice rehabilitation imposes on patients. In our cohort, all patients received reimbursement for their VP, thus a socio-economic bias can be ruled out, similar to, for example, the study population of Kress et al from Germany.…”

Analysis of Factors Affecting the Longevity of Voice Prosthesis Following Total Laryngectomy with a Review of Literature

“…The prosthesis device life can also vary across regions due to number of reasons, including diet, patient preference, reimbursement and voice expectations, and tolerance of periods of minor leakage prior to replacement. The life of the voice prosthesis has been reported to be anywhere between 2 and 14 months based on the different group of patients, devices, and regions studied [10,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] (Table 4).…”

In vitro biofilm growth on modern voice prostheses

“…In order to further improve the patients quality of life by reducing the number of prosthesis replacements per year, the valve opening pressures have been standardized and more robust flap materials, such as Teflon, polyurethane, and silicone, incorporated with silver oxide have been introduced to inhibit microbial colonization . However, the achieved benefit remains questionable, as multiple studies by different researchers show wide variances of the in vivo device lifetimes, even in the same patients . A critical overview on the in vivo performances of modern voice prosthesis was published by Kress et al in 2014, which also discusses the cost‐efficiency of the high priced Provox ActiValve and the clinical performance of the Blom Singer Advantage prostheses.…”

“…[8][9][10] However, the achieved benefit remains questionable, as multiple studies by different researchers show wide variances of the in vivo device lifetimes, even in the same patients. 11,12 A critical overview on the in vivo performances of modern voice prosthesis was published by Kress et al 13 in 2014, which also discusses the cost-efficiency of the high priced Provox ActiValve and the clinical performance of the Blom Singer Advantage prostheses. These speciality prostheses have been designed to better withstand biofilm formation.…”