Premium
Voice restoration after laryngectomy: Experience with the Blom–Singer extended‐wear indwelling tracheoesophageal voice prosthesis
Author(s) -
Leder Steven B.,
Erskine M. Cara
Publication year - 1997
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/(sici)1097-0347(199709)19:6<487::aid-hed5>3.0.co;2-v
Subject(s) - laryngectomy , voice prosthesis , medicine , prosthesis , audiology , esophageal speech , surgery , larynx
Background The Blom‐Singer tracheoesophageal voice prosthesis has undergone continuous design modifications during the last 18 years to make it more effective, anatomically compatible, and easier to use. This evolution continues with the recent introduction of an indwelling‐style voice prosthesis intended for use by individuals who are unable or disinclined to use a self‐removable‐style voice prosthesis. The a priori set‐lifespan goal of the indwelling prosthesis was 180 days. Methods The present investigation describes the experience of 81 consecutive participants who used a total of 206 indwelling voice prostheses. Selection criteria included total laryngectomy and either primary ( n = 35) or secondary ( n = 46) tracheoesophageal puncture. All participants had external‐beam radiotherapy either pre‐ or postlaryngectomy. Specifically, lifespan of the prosthesis, the effects and clinical management of fungal colonization, and participant satisfaction with this style prosthesis were studied. Results A prosthesis use rate of 90% was observed. Group 1 prostheses (without fungal colonization and without Nystatin® therapy) exhibited a lifespan significantly longer than did group 2 prostheses (with fungal colonization and prior to Nystatin® therapy) (sample mean [ X ] = 185.6 days versus 80.6 days; p < .05). Group 3 prostheses (following Nystatin® therapy) also exhibited a lifespan significantly longer than that of group 2 prostheses ( X = 156.1 days versus 80.6 days; p < .05). Lifespans of group 1 and group 3 prostheses were not significantly different ( p < .05). Conclusions The extended‐wear, indwelling voice prosthesis achieved its a priori lifespan goal of 180 days (6 months) with almost uniform patient preference and without risk of increased complications. When fungal colonization was present, Nystatin® therapy significantly prolonged prosthesis lifespan. © 1997 John Wiley & Sons, Inc. Head Neck 19:487–493, 1997.