Long-Term Results with Consistent Use of Indwelling Voice Prosthesis in Albania

Besim Boçi, Klevis Thomai, Roven Sinani

Abstract


Objective: To assess long term results with use of indwelling voice prosthesis (Provox) for vocal rehabilitation after total laryngectomy in Albania. Design: Retrospective clinical analysis Patients: One hundred four patients (101 men and 3 women) from May 2008, through April 2014. Interventions: Standard wide-field total laryngectomy (89 patients), or total laryngectomy and circumferential pharyngeal resection (15 patients), and 44 prosthesis replacements. Prostheses remained in situ during 121080 days. Results: Median patient-device follow- up was 38.7 months. Mean actuarial device lifetime for all indications for replacement was 807.2 days. Main indications for replacement were device related, ie, leakage through the prosthesis (41.3%) or fistula related, ie, leakage around the prosthesis ( 33.3% ), and hypertrophy and/or infection of the fistula ( 4.2% ). Adverse events occurred in 12.5% of all replacements mostly solvable by a shrinkage period of 7 days, adequate sizing and/or antibiotic treatment. Significant clinical factors for increased device life time were no radiotherapy and age older than 70 years (p<02). Success rate with respect to voice quality (ie, fair to excellent rating) was 83.2%. Conclusion: The consistent use of indwelling voice prosthesis shows a high success rate of prosthetic vocal rehabilitation, in terms of the percentage of long-term users (90.9%), and a fair to excellent voice quality (83.2% of patients).

Keywords: Device lifetime, indications for replacement (device or fistula related ), adverse events, and voice quality.


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DOI: http://dx.doi.org/10.0001/(aj).v3i5.596

DOI (PDF): http://dx.doi.org/10.0001/(aj).v3i5.596.g1461

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