In Situ Lifetime, Causes for Replacement, and Complications of the Provox^TMVoice Prosthesis

Abstract

One hundred Provox voice prostheses consecutively inserted in 37 patients and replaced only when phonation was impaired or complications noted were analyzed for in situ lifetime, causes for replacement, and complications. The mean in situ lifetime was 311 days. Actuarial analysis (Kaplan-Meier method) of the in situ lifetime revealed that 65.9%, 23.7%, and 16.4% of the voice prosthesis were still in situ by the 6th, 12th, and 18th postinsertion month. Cause for replacement was salivary leakage through the prosthesis valve, salivary leakage around the prosthesis, deterioration of the prosthesis, and excessive crusting resulting in increased airflow resistance in 33%, 27%, 24%, and 16% of cases, respectively. Complications included granulation tissue formation, cervical cellulitis, necrosis of the tracheoesophageal puncture, tracheostomal stenosis, and swallowing impairment in six, two, one, three, and one patient, respectively.

Factors influencing the longevity and replacement frequency of Provox voice prostheses

“…(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) Since the average success rate of oesophageal speech is only 33%, the use of voice prostheses is often the preferred method for speech rehabilitation. (19)(20)(21) The success rate of the Provox prosthesis in achieving speech in the present study (i.e.…”

“…The shortest duration of Provox prosthesis use (before replacement) was reported to be 3.6 months, while the longest was reported to be 10.3 months. (9,17) Demir et al reported that the minimum and maximum duration of Provox prosthesis use (before replacement) was 1 month and 49 months, respectively; the mean duration was 24 months. (14) The long duration of prosthesis use was attributed to the fact that patients were carefully selected, the patient-physician relationship was maintained via strict follow-ups and prosthesis care was conducted regularly.…”

Postlaryngectomy Vocal Rehabilitation: Assessment Using a Validated Questionnaire in 51 Patients

“…Having already acclimatized, it would have been difficult to convince them otherwise. Most patients changed the filter every 24 h which was in keeping with other studies [3,[16][17][18] . Many patients scored only modestly on the reduction of mucus following the use of the humidification system.…”

Insertion of a tracheoesophageal speech valve: a novel approach in a difficult situation

“…Leakage, both through the centre of the valve and around the periphery, is a common problem, occurring in up to 27 per cent of patients. 6 On average, speech valves need to be replaced every three to four months. 7,8 The replacement procedure is uncomfortable for the patient.…”