Results of Voice Rehabilitation With Provox Prosthesis and Factors Affecting the Voice Quality

Dabholkar, Jyoti; Kapre, Neeti Madan; Gupta, Harsh K.

doi:10.1016/j.jvoice.2015.01.003

Cited by 8 publications

(7 citation statements)

References 12 publications

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“…There is no consensus on the effect of irradiation on the complication rate of Provox® insertion . The complication rates according to irradiation in all patients and the jejunal or esophageal insertion cohorts were investigated.…”

Section: Resultsmentioning

confidence: 99%

“…This suggests that secondary Provox® insertion could be a useful tool for voice restoration following TPL with free jejunal reconstruction. A previous study showed that irradiation therapy was not a contraindication to primary indwelling prosthesis insertion and did not decrease the success rate of Provox® insertion after TL . However, following extensive resection such as that used in TPL, secondary insertion might be preferable especially in previously irradiated patients because of the risk of peristomal and fistula wall necrosis .…”

Section: Discussionmentioning

confidence: 99%

“…A previous study showed that irradiation therapy was not a contraindication to primary indwelling prosthesis insertion 5 and did not decrease the success rate of ProvoxV R insertion after TL. 16 However, following extensive resection such as that used in TPL, secondary insertion might be preferable especially in previously irradiated patients because of the risk of peristomal and fistula wall necrosis. 5,23 Aside from showing that voice restoration with indwelling voice prostheses is achievable for patients following TPL with free jejunum reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…There is no consensus on the effect of irradiation on the complication rate of ProvoxV R insertion. 5,15,16 The complication rates according to irradiation in all patients and the jejunal or esophageal insertion cohorts were investigated. As shown in Table III, in the overall population and the jejunal insertion cohort, there were no significant differences in complication or local infection rates between patients who did or did not undergo irradiation.…”

Section: Differences In Complication Rates According To Irradiation Smentioning

confidence: 99%

See 3 more Smart Citations

Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction

Fukushima

Kanazawa

Kawabata

et al. 2017

Laryngoscope Investig Oto

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ObjectivesTotal pharyngolaryngectomy with free jejunal reconstruction is often performed in patients with hypopharyngeal carcinoma. However, postoperative speechlessness significantly decreases patient quality of life. We investigated whether Provox® insertion could preserve speech after total pharyngolaryngectomy with free jejunal reconstruction.Study DesignRetrospective chart review.MethodsA total of 130 cases of secondary Provox® insertions after total pharyngolaryngectomy with free jejunal reconstruction were analyzed. Communication outcomes were compared using the Head and Neck Cancer Understandability of Speech Subscale. Outcomes and complications associated with insertion site (jejunal insertion vs. esophageal insertion) and adjuvant irradiation therapy were also evaluated.ResultsProvox® insertion had favorable communication outcomes in 102 cases (78.4%). Neither the insertion site nor irradiation affected the communication outcome. Complications were observed in 20 cases (15.4%). Local infection was the most common complication. Free jejunal insertion, in which the resection range was enlarged, had a lower complication rate than did esophageal insertion, and its complication rate was unaffected by previous irradiation. For all patients, the hospitalization duration and duration of speechlessness were 13.4 days and 14.6 months, respectively. Patients receiving jejunal insertions had a significantly shorter hospitalization duration than did those receiving esophageal insertions. Unlike Provox®2, Provox®Vega significantly reduced the complication rate to zero.ConclusionFor jejunal inserson of a Provox® prosthetic, a sufficient margin can be maintained during total pharyngolaryngectomy and irradiation can be performed, and satisfactory communication outcomes were observed. Provox® insertion after total pharyngolaryngectomy with free jejunal reconstruction should be considered the standard therapy for voice restoration.Level of Evidence4.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Differences In Complication Rates According To Irradiation Smentioning

confidence: 99%

See 2 more Smart Citations

Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction

Fukushima

Kanazawa

Kawabata

et al. 2017

Laryngoscope Investig Oto

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“…In several studies, tracheoesophageal speech with a voice prosthesis yields speech that is considered more normal than esophageal speech [ 342 , 343 ]. In addition, functional outcome analyses have found that tracheoesophageal speech with a voice prosthesis yields a good voice quality [ 344 , 345 ]. Voice prostheses may be inserted either at the time of total laryngectomy (primary) or at a later stage (secondary).…”

Section: Guidelines For Surgical Treatment Of Laryngeal Cancermentioning

confidence: 99%

Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery

Ahn

Hong

Kwon

et al. 2017

Clin Exp Otorhinolaryngol

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Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to develop clinical practice guidelines for the surgical treatment of laryngeal cancer. This Task Force conducted a systematic search of the EMBASE, MEDLINE, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to the key questions. Evidence-based recommendations were then created on the basis of these articles. An external expert review and Delphi questionnaire were applied to reach consensus regarding the recommendations. The resulting guidelines focus on the surgical treatment of laryngeal cancer with the assumption that surgery is the selected treatment modality after a multidisciplinary discussion in any context. These guidelines do not, therefore, address non-surgical treatment such as radiation therapy or chemotherapy. The committee developed 62 evidence-based recommendations in 32 categories intended to assist clinicians during management of patients with laryngeal cancer and patients with laryngeal cancer, and counselors and health policy-makers.

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Perceptual Voice and Speech Analysis after Supraglottic Laryngeal Closure for Chronic Aspiration in Head and Neck Cancer

Vlantis

Yeung

et al. 2020

The Laryngoscope

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Objectives/Hypothesis To evaluate the voice and speech outcomes after tubed supraglottic laryngeal closure (TSLC) surgery to treat chronic aspiration after radiotherapy for head and neck cancer. Study Design A retrospective case‐control study. Methods The data of patients who underwent radiotherapy for head and neck cancer and who later required total laryngectomy or TSLC for chronic aspiration between 2004 and 2017 were retrieved from a dysphagia clinic. Preoperative and postoperative voice and speech were assessed by the GRBAS and INFVo rating scales. Control subjects who underwent radiotherapy alone or total laryngectomy with a tracheoesophageal prosthesis for other indications were recruited for comparison. Results Of 15 patients who underwent a TSLC with a mean age of 57.3 years (45–75 years), 13 were male and 2 female. All patients had a history of nasopharyngeal carcinoma. The success rate of speech production using their own larynx following an intact TSLC was 64%. There was no statistically significant difference in voice and speech ratings between preoperative and TSLC subjects on the GRBAS (P = .32) and INFVo scales (P = .57), although the quality of voice appeared to deteriorate after TSLC. However, the INFVo scale for impression, intelligibility and unsteadiness of the voice after TSLC was statistically significantly better than for laryngectomy with tracheoesophageal speech. Conclusions A tubed supraglottic laryngeal closure controls chronic aspiration while preserving the larynx for phonation, and results in a better voice and speech quality than a laryngectomy with a voice prosthesis. Level of Evidence 4 Laryngoscope, 131:E1616–E1623, 2021

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Results of Voice Rehabilitation With Provox Prosthesis and Factors Affecting the Voice Quality

Cited by 8 publications

References 12 publications

Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction

Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction

Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery

Perceptual Voice and Speech Analysis after Supraglottic Laryngeal Closure for Chronic Aspiration in Head and Neck Cancer

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