Abstract
The use of the tracheoesophageal (T-E) silicone rubber voice prosthesis is the most effective and well-established procedure to restore the voice in patients after laryngectomy. The prosthesis is usually well-tolerated with only minor complications. Severe complications are rare. In this article we present our experience with the prosthetic technique at the Clinic of Otorhinolaryngology and Head and Neck Surgery in University Hospital in Martin, Slovakia between the years 2005–2013 and report a case of a 48-year-old man with secondary prosthesis inserted through a T-E shunt 16 months after laryngectomy. On the 6th day after the insertion, the shunt decayed. After prosthesis removal the tissue defect was sutured. Due to repetitive tissue decay, reconstruction of the trachea and esophagus became necessary. On the 10th day, peritracheoesophageal fistula developed and gastrostomy was performed. Because of intense fibrotic and inflammatory changes, further reconstruction was not indicated. After 6 months, esophageal stenosis occurred and endoscopic dilation under local anaesthesia was performed. The T-E voice prosthesis has become one of the choices for voice rehabilitation following total laryngectomy and may improve the patient’s long-term quality of life. The overall risk of severe complications seems relatively low. Nonetheless, some complications might be challenging and might require specific management.
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References
Birk S, Michaeli P, Kapsreiter M, Alexiou C (2009) [Dislocation of voice prostheses. Interdisciplinary management of diagnostics and treatment][Article in German]. HNO 57(11):1126–1130
Boscolo-Rizzo P, Zanetti F, Carpene S, Da Mosto MC (2008) Long-term results with tracheoesophageal voice prosthesis: primary versus secondary TEP. Eur Arch Otorhinolaryngol 265:73–77
Bozec A, Poissonnet G, Chamorey E, Demard F, Santini J, Peyrade F, Ortholan C, Benezery K, Thariat J, Sudaka A, Anselme K, Adrey B, Giacchero P, Dassonville O (2010) Results of vocal rehabilitation using tracheoesophageal voice prosthesis after total laryngectomy and their predictive factors. Eur Arch Otorhinolaryngol 267(5):751–758
Bozzo C, Meloni F, Trignano M, Profili S (2014) Mediastinal abscess and esophageal stricture following voice prosthesis insertion. Auris Nasus Larynx 41(2):229–233
Denholm SW, Fielder CP (1994) Submental abscess: an unusual delayed complication of primary Blom-Singer valve insertion. J Laryngol Otol 108(12):1093–1094
Imre A, Pınar E, Callı C, Sakarya EU, Oztürkcan S, Oncel S, Katılmış H (2013) Complications of tracheoesophageal puncture and speech valves: retrospective analysis of 47 patients. Kulak Burun Bogaz Ihtisas Dergisi 23(1):15–20
Laccourreye O, Ménard M, Crevier-Buchman L, Couloigner V, Brasnu D (1997) In situ lifetime, causes for replacement, and complications of the Provox voice prosthesis. Laryngoscope 107(4):527–530
Leonhard M, Schneider-Stickler B (2015) Voice prostheses, microbial colonization and biofilm formation. Adv Exp Med Biol 830:123–136
Lewin JS, Hutcheson KA, Barringer DA, Croegaert LE, Lisec A, Chambers MS (2012) Customization of the voice prosthesis to prevent leakage from the enlarged tracheoesophageal puncture: results of a prospective trial. Laryngoscope 122(8):1767–1772
Lukinović J, Bilić M, Raguz I, Zivković T, Kovac-Bilić L, Prgomet D (2012) Overview of 100 patients with voice prosthesis after total laryngectomy-experience of single institution. Coll Antropol 36(Suppl 2):99–102
Mobashir MK, Basha WM, Mohamed AE, Anany AM (2014) Management of persistent tracheoesophageal puncture. Eur Arch Otorhinolaryngol 271(2):379–383
Rosso M, Sirić L, Tićac R, Starcević R, Segec I, Kraljik N (2012) Perceptual evaluation of alaryngeal speech. Coll Antropol 36(Suppl 2):115–118
Ruth H, Davis WE, Renner G (1985) Deep neck abscess after tracheoesophageal puncture and insertion of a voice button prosthesis. Otolaryngol Head Neck Surg 93(6):809–811
Sebova-Sedenkova I (2010) Primary prosthetic voice rehabilitation in patients after laryngectomy – part II. Otorhinolaryngol Head Neck Surg 4(1):15–18
Shuaib SW, Hutcheson KA, Knott JK, Lewin JS, Kupferman ME (2012) Minimally invasive approach for the management of the leaking tracheoesophageal puncture. Laryngoscope 122(3):590–594
Singer MI, Blom ED (1980) An endoscopic technique for restoration of voice after laryngectomy. Ann Otol Rhinol Laryngol 89(6 Pt 1):529–533
Spiro JD, Spiro RH (1990) Retropharyngeal abscess and carotid hemorrhage following tracheoesophageal puncture and voice prosthesis insertion: a case report. Otolaryngol Head Neck Surg 102(6):762–763
Talpaert MJ, Balfour A, Stevens S, Baker M, Muhlschlegel FA, Gourlay CW (2014) Candida biofilm formation on voice prostheses. J Med Microbiol. doi:10.1099/jmm.0.078717-0. [Epub ahead of print]
van der Molen L, Kornman AF, Latenstein MN, van den Brekel MW, Hilgers FJ (2013) Practice of laryngectomy rehabilitation interventions: a perspective from Europe/the Netherlands. Curr Opin Otolaryngol Head Neck Surg 21(3):230–238
van Weissenbruch R, Albers FWJ (1993) Vocal rehabilitation after total laryngectomy using the Provox voice prosthesis. Clin Otolaryngol Allied Sci 18:359–364
Wu L, Wan C, Wang S, Wan M (2013) Improvement of electrolaryngeal speech quality using a supraglottal voice source with compensation of vocal tract characteristics. IEEE Trans Biomed Eng 60(7):1965–1974
Acknowledgements
The study was supported by VEGA No. 1/0416/12 and Project Virtual and Simulation Tuition as a New Form of Education at JFM CU in Martin (ITMS 26110230071).
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The authors declare no conflicts of interest in relation to this article.
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Calkovsky, V., Hajtman, A. (2014). Primary Prosthetic Voice Rehabilitation in Patients After Laryngectomy: Applications and Pitfalls. In: Pokorski, M. (eds) Respiratory Carcinogenesis. Advances in Experimental Medicine and Biology(), vol 852. Springer, Cham. https://doi.org/10.1007/5584_2014_104
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DOI: https://doi.org/10.1007/5584_2014_104
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