Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

Tracheoesophageal voice puncture (TEP) coupled with the use of voice prosthesis has been considered as the gold standard for speech rehabilitation in patients of advanced laryngeal/hypopharyngeal carcinomas, who have undergone a total laryngectomy with or without partial pharyngectomy. Although prosthetic voice rehabilitation is commonly practiced worldwide including India, there is a paucity of published Indian data, more so in the current era of organ conservation. This study included 60 laryngectomized patients with a prosthetic voice rehabilitation at a tertiary cancer center in South India between January 1, 2010 and December 31, 2013. Among the 60 patients, the primary site of cancer was the larynx in 43 patients and hypopharynx in the remaining 17. All patients had undergone a primary TEP insertion, 55 in the upfront setting and five in the salvage (post-radiation/chemo-radiation) setting. The ability to retain a successful trachea-esophageal speech on follow-up (median 15.5 months) in our series was around 82%. The mean device life of voice prosthesis in our patient cohort was 16 months. There was surprisingly no significant difference in the prosthesis device life on correlation with age, co-morbidities, habitat, literacy status, pre-operative tracheostomy, setting of surgery, and the extent of surgery. Our series has successfully demonstrated the safety and feasibility of using primary TEP coupled with the use of voice prosthesis for voice rehabilitation in properly selected and motivated patients of advanced laryngeal and hypopharyngeal carcinomas across all clinical settings. A mean device life of 16 months makes prosthetic voice rehabilitation, an attractive as well as a financially viable option for patients in a resource constrained setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Tang CG, Sinclair CF (2015) Voice restoration after total laryngectomy. Otolaryngol Clin N Am 48:687–702

    Article  Google Scholar 

  2. Abemayor E (2017) Prosthetic voice rehabilitation following laryngectomy: it’s the archer not the arrow. JAMA Otolaryngol Head Neck Surg 143:72

  3. Brown DH, Hilgers FJ, Irish JC, Balm AJ (2003) Postlaryngectomy voice rehabilitation: state of the art at the millennium. World J Surg 27:824–831

    Article  PubMed  Google Scholar 

  4. Chone CT, Gripp FM, Spina AL, Crespo AN (2005) Primary versus secondary tracheoesophageal puncture for speech rehabilitation in total laryngectomy: long-term results with indwelling voice prosthesis. Otolaryngol Head Neck Surg 133:89–93

    Article  PubMed  Google Scholar 

  5. 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 21:230–238

    Article  PubMed  Google Scholar 

  6. Guttman D, Mizrachi A, Hadar T, Bachar G, Hamzani Y, Marx S, Shvero J (2013) Post-laryngectomy voice rehabilitation: comparison of primary and secondary tracheoesophageal puncture. Isr Med Assoc J 15:497–499

    PubMed  Google Scholar 

  7. Naunheim MR, Remenschneider AK, Scangas GA, Bunting GW, Deschler DG (2016) The effect of initial tracheoesophageal voice prosthesis size on postoperative complications and voice outcomes. Ann Otol Rhinol Laryngol 125:478–484

    Article  PubMed  Google Scholar 

  8. Cheng E, Ho M, Ganz C, Shaha A, Boyle JO, Singh B et al (2006) Outcomes of primary and secondary tracheoesophageal puncture: a 16-year retrospective analysis. Ear Nose Throat J 85:264–267

    Google Scholar 

  9. Polat B, Orhan KS, Kesimli MC, Gorgulu Y, Ulusan M, Deger K (2015) The effects of indwelling voice prosthesis on the quality of life, depressive symptoms, and self-esteem in patients with total laryngectomy. Eur Arch Otorhinolaryngol 272:3431–3437

    Article  PubMed  Google Scholar 

  10. Thylur DS, Villegas BC, Fisher LM, Sinha UK, Kokot N (2016) Device life of two generations of Provox voice prostheses. Ann Otol Rhinol Laryngol 125:501–507

    Article  PubMed  Google Scholar 

  11. Kress P, Schäfer P, Schwerdtfeger FP, Rösler S (2014) Are modern voice prostheses better? A lifetime comparison of 749 voice prostheses. Eur Arch Otorhinolaryngol 271:133–140

    Article  CAS  PubMed  Google Scholar 

  12. Lewin JS, Baumgart LM, Barrow MP, Hutcheson KA (2017) Device life of the tracheoesophageal voice prosthesis revisited. JAMA Otolaryngol Head Neck Surg 143:65–71

  13. Glazer TA, Meraj T, Lyden TH, Spector ME (2016) In-office secondary tracheoesophageal puncture with immediate prosthesis placement. Otolaryngol Head Neck Surg 155:360–363

    Article  PubMed  Google Scholar 

  14. Gitomer SA, Hutcheson KA, Christianson BL, Samuelson MB, Barringer DA, Roberts DB, Hessel AC, Weber RS, Lewin JS, Zafereo ME (2016) Influence of timing, radiation, and reconstruction on complications and speech outcomes with tracheoesophageal puncture. Head Neck 38:1765–1771

  15. Elving GJ, Van Weissenbruch R, Busscher HJ, Van Der Mei HC, Albers FW (2002) The influence of radiotherapy on the lifetime of silicone rubber voice prostheses in laryngectomized patients. Laryngoscope 112:1680–1683

    Article  CAS  PubMed  Google Scholar 

  16. Gultekin E, Yelken K, Garca MF, Develioglu ON, Kulekci M (2011) Effects of neck dissection and radiotherapy on short-term speech success in voice prosthesis restoration patients. J Voice 25:245–248

    Article  PubMed  Google Scholar 

  17. Dayangku Norsuhazenah PS, Baki MM, Mohamad Yunus MR, Sabir Husin Athar PP, Abdullah S (2010) Complications following tracheoesophageal puncture: a tertiary hospital experience. Ann Acad Med Singap 39:565–564

    PubMed  Google Scholar 

  18. Stafford FW (2003) Current indications and complications of tracheoesophageal puncture for voice restoration after laryngectomy. Curr Opin Otolaryngol Head Neck Surg. 11:89–95

    Article  PubMed  Google Scholar 

  19. Messing BP, Kim M, Hirata R, Thompson CB, Gebhart S, Sugar EA, Saunders JM, Sciubba J, Califano JA (2015) Evaluation of prophylaxis treatment of Candida in alaryngeal patients with tracheoesophageal voice prostheses. Laryngoscope 125:1118–1123

    Article  PubMed  Google Scholar 

  20. Somogyi-Ganss E, Chambers MS, Lewin JS, Tarrand JJ, Hutcheson KA (2017) Biofilm on the tracheoesophageal voice prosthesis: considerations for oral decontamination. Eur Arch Otorhinolaryngol 274:405–413

  21. Lorenz KJ, Grieser L, Ehrhart T et al (2010) Prosthetic voice restoration after laryngectomy. The management of fistula complications with anti-reflux medications. HNO 58:919–926

    Article  CAS  PubMed  Google Scholar 

  22. Lorenz KJ, Kraft K, Graf F et al (2015) Importance of cellular tight junction complexes in the development of periprosthetic leakage after prosthetic voice rehabilitation. HNO 63:171–181

    Article  CAS  PubMed  Google Scholar 

  23. Pattani KM, Morgan M, Nathan CO (2009) Reflux as a cause of tracheoesophageal puncture failure. Laryngoscope 119:121–125

    Article  PubMed  Google Scholar 

  24. Soukka T, Tenovuo J, Lenander-Lumikari M (1992) Fungicidal effect of human lactoferrin against Candida albicans. FEMS Microbiol Lett 69:223

    Article  CAS  PubMed  Google Scholar 

  25. Chaturvedi P, Syed S, Pawar PV, Kelkar R, Biswas S, Datta S, Nair D, Chaukar D, D'cruz AK (2014) Microbial colonization of Provox voice prosthesis in the Indian scenario. Indian J Cancer 51:184–188

    Article  CAS  PubMed  Google Scholar 

  26. Busscher HJ, van Hoogmoed CG, Geertsema-Doornbusch GI, van der Kuijl Booij M, van der Mei HC (1997) Streptococcus thermophilus and its biosurfactants inhibit adhesion by Candida spp. on silicone rubber. Appl Environ Microbiol 63:3810–3817

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Timmermans AJ, Harmsen HJ, Bus-Spoor C, Buijssen KJ, van As-Brooks C, de Goffau MC, Tonk RH, van den Brekel MW, Hilgers FJ, van der Laan BF (2016) Biofilm formation on the Provox ActiValve: composition and ingrowth analyzed by Illumina paired-end RNA sequencing, fluorescence in situ hybridization, and confocal laser scanning microscopy. Head Neck 38 Suppl 1:E432–E440

  28. Jiang N, Kearney A, Damrose EJ (2016) Tracheoesophageal fistula length decreases over time. Eur Arch Otorhinolaryngol 273:1819–1824

    Article  PubMed  Google Scholar 

  29. Friedlander E, Pinacho Martínez P, Poletti Serafini D, Martín-Oviedo C, Martínez Guirado T, Scola Yurrita B (2016) Practical management of periprosthetic leakage in patients rehabilitated with a Provox® 2 voice prosthesis after total laryngectomy. Acta Otorrinolaringol Esp 67:301–305

  30. Erdim I, Sirin AA, Baykal B, Oghan F, Guvey A, Kayhan FT (2016) Treatment of large persistent tracheoesophageal peristomal fistulas using silicon rings. Braz J Otorhinolaryngol. https://doi.org/10.1016/j.bjorl.2016.06.011

  31. Krishnamurthy A (2014) A novel approach in the management of an aspirated voice prosthesis in a laryngectomized patient. Indian J Surg Oncol 5:255–256

    Article  PubMed  PubMed Central  Google Scholar 

  32. Cornu AS, Vlantis AC, Elliott H, Gregor RT (2003) Voice rehabilitation after laryngectomy with the Provox voice prosthesis in South Africa. J Laryngol Otol 117:56–59

    Article  PubMed  Google Scholar 

  33. Cruz S, Viana R, Guimarães J, Fernandes J (2014) Joaquim Castro Silva, Eurico Monteiro, Tracheoesophageal voice prosthesis outcomes: success or Insucess? Int J Otolaryngol Head Neck Surg 3:14–22

    Article  Google Scholar 

  34. Hilgers FJ, Schouwenburg PF (1990) A new low-resistance, self-retaining prosthesis (Provox) for voice rehabilitation after total laryngectomy. Laryngoscope 100:1202–1207

    Article  CAS  PubMed  Google Scholar 

  35. de Carpentier JP, Ryder WD, Saeed SR, Woolford TJ (1996) Survival times of Provox valves. J Laryngol Otol 110:37–42

    PubMed  Google Scholar 

  36. 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 107:527–530

    Article  CAS  PubMed  Google Scholar 

  37. Heaton JM, Parker AJ (1994) Indwelling tracheo-oesophageal voice prostheses post-laryngectomy in Sheffield, UK: a 6-year review. Acta Otolaryngol 114:675–678

    Article  CAS  PubMed  Google Scholar 

  38. Ackerstaff AH, Hilgers FJ, Meeuwis CA et al (1999) Multi-institutional assessment of the Provox 2 voice prosthesis. Arch Otolaryngol Head Neck Surg 125:167–173

    Article  CAS  PubMed  Google Scholar 

  39. Graville D, Gross N, Andersen P, Everts E, Cohen J (1999) The long-term indwelling tracheoesophageal prosthesis for alaryngeal voice rehabilitation. Arch Otolaryngol Head Neck Surg 125:288–292

    Article  CAS  PubMed  Google Scholar 

  40. Op de Coul BM, Hilgers FJ, Balm AJ, Tan IB, van den Hoogen FJ, van Tinteren H (2000) A decade of postlaryngectomy vocal rehabilitation in 318 patients: a single institution’s experience with consistent application of provox indwelling voice prostheses. Arch Otolaryngol Head Neck Surg 126:1320–1328

    Article  Google Scholar 

  41. Schafer P, Klutzke N, Schwedtfeger FP (2001) Voice restoration with voice prosthesis after total laryngectomy. Assessment of survival time of 378 Provox-1, Provox-2 and Blom-Singer voice prosthesis. Laryngorthinootologie 80:667–681

    Google Scholar 

  42. Free RH, Busscher HJ, Elving GJ, van der Mei HC, van Weissenbruch R, Albers FW (2001) Biofilm formation on voice prostheses: in vitro influence of probiotics. Ann Otol Rhinol Laryngol 110:946–951

    Article  CAS  PubMed  Google Scholar 

  43. Lequeux T, Badreldin A, Saussez S, Thill MP, Oujjan L, Chantrain G (2003) A comparison of survival lifetime of the Provox and the Provox2 voice prosthesis. J Laryngol Otol 117:875–878

    Article  CAS  PubMed  Google Scholar 

  44. Ramalingam W, Chikara D, Rajagopal G, Mehta AR, Sarkar S (2007) Tracheo-esophageal puncture (TEP) for voice rehabilitation in laryngectomised patients Blom-singer® vs Provox® prosthesis : our experience. Med J Armed Forces India 63:15–18

    Article  PubMed  PubMed Central  Google Scholar 

  45. Yenigun A, Eren SB, Ozkul MH, Tugrul S, Meric A (2015) Factors influencing the longevity and replacement frequency of Provox voice prostheses. Singap Med J 56:632–636

    Article  Google Scholar 

  46. Serra A, Di Mauro P, Spataro D, Maiolino L, Cocuzza S (2015) Post-laryngectomy voice rehabilitation with voice prosthesis: 15 years’ experience of the ENT Clinic of University of Catania. Retrospective data analysis and literature review. Acta Otorhinolaryngol Ital 35:412–419

    CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Surgical Oncology, Cancer Institute (WIA), 38, Sardar Patel Rd, Adyar, Chennai, 600036, India

    Arvind Krishnamurthy

  2. Preventive Oncology, Cancer Institute (WIA), 38, Sardar Patel Rd, Adyar, Chennai, 600036, India

    Suhaildeen Khwajamohiuddin

Authors
  1. Arvind Krishnamurthy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Suhaildeen Khwajamohiuddin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Arvind Krishnamurthy.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Krishnamurthy, A., Khwajamohiuddin, S. Analysis of Factors Affecting the Longevity of Voice Prosthesis Following Total Laryngectomy with a Review of Literature. Indian J Surg Oncol 9, 39–45 (2018). https://doi.org/10.1007/s13193-017-0700-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13193-017-0700-z

Keywords

Search

Navigation