Long‐Term Results of Provox ActiValve, Solving the Problem of Frequent Candida‐ and “Underpressure”‐Related Voice Prosthesis Replacements

Abstract

Long-term results of Provox General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Results: Median device-related lifetime of Provox ActiValve, replaced for leakage through the device and those still in situ at the date of data collection (N=32), was 337 days (mean 376 days): a statistically significant 16-fold increase compared to Provox2 (P<0.001). In 10 patients replacement was fistula-related (median after 86 days): esophageal pouch (N=4), fistula granulation (N=3), extrusion of the device (N=2), and periprosthetic leakage (N=1).86% of patients used a special lubricant to diminish 'stickiness' of the valve. ProvoxActiValve was preferred by 90% of the patients completing the trial specific questionnaire.Conclusions: For patients requiring frequent device-related replacements, Provox ActiValve, also long-term, provides a true solution and thereby is a valuable addition to prosthetic voice rehabilitation.

Satisfaction and Quality of Life in Laryngectomees after Voice Prosthesis Rehabilitation

“…Electrolaryngeal speech has been described as mechanical sounding and is currently the least preferred method of nonlaryngeal communication by listeners and clinicians [23,25] . In the literature, prosthetic voice rehabilitation has proved to be successful in restoring proper speech function in over 90% of patients and is currently the preferred method in most developed countries [5,6] .…”

“…The Provox (Atos Medical, Hörby, Sweden) voice prosthesis, introduced in 1990 [6,7] , is currently the most popular prosthesis for voice rehabilitation [2] . Recently, a modified valve named Provox2 has been developed that can be inserted thanks to an anterograde replacement technique, which makes it easier to be replaced [8] .…”

“…Since its introduction by Singer and Blom [4] in 1980, it has gained increasing popularity. Nowadays, the implantable valved prostheses seem to be the best and most popular solution for postlaryngectomy voice rehabilitation [5] , and are successful in 90% of cases [6] .…”

Device Life of the Tracheoesophageal Voice Prosthesis Revisited

“…In other words, specialty prostheses are typically placed in patients who experience suboptimal device life using standard prostheses because of unique problems or characteristics related to physiology, anatomy, airflow, etc. 15,16 Our results showed that specialty prostheses as a consortium, offered users an average duration comparable to standard devices, but they did not extend device life beyond the group level. That is, both the median device life for standard and specialty devices approximated 2 months.…”

Practice of laryngectomy rehabilitation interventions

“…In a subcategory (15%) of patients this internal leakage occurs very frequently, and for these patients the solution is a specialize VP, which uses tiny magnets to obtain an active closure of the valve. [29][30][31] The second reason for VP replacement/adjustment is peripheral leakage. Normal healing processes cause a gradual decrease of the surgical oedema at the TEP site, and the subsequent shortening of the TEP tract makes the VP too long.…”