The article is devoted to the problem of voice rehabilitation of patients after laryngectomy. Modern possibilities of repairing laryngeal vocal function, methods for extending the lifetime of voice prostheses are considered. The author’s method of prevention of infection of vocal prostheses using the antimicrobial photodynamic therapy (PDT) with chlorin-type photosensitizer Radagel is presented. Performing antimicrobial PDT of vocal prostheses increased the average operating time to 11.9 months compared to the control group (6.8 months), where a monthly dose of 150 mg of fluconazole was used for prevention. The method developed by the authors makes it possible to significantly extend the lifetime of vocal prostheses, is devoid of adverse events, is well tolerated by patients.

The authors consider the possibilities of pain management during photodynamic therapy (PDT) of visible tumors based on the observation of 102 patients. Of the total number of patients, 62 had verified basal cell skin cancer, 10 people - squamous cell skin cancer, another 10 - oral and oropharynx mucosa cancer, 8 - oral leukoplakia and dysplasia, in 6 - lower lip cancer, in 4 - breast cancer, in 2 - other localizations of neoplasms. In 15 patients, nonsteroidal anti-inflammatory drugs (NSAID) were used as pain management, in 69 - a combination of NSAID with tramadol, in 14 - nerve block anesthesia, in 4 - PDT was performed under general anesthesia. The intensity of pain syndrome during laser irradiation of the tumor was assessed on the verbal rating scale (VRS). The absence of pain was recorded in 9% of cases. Mild pain was noted by 58% of patients, moderate pain - 20%, severe pain - 10%, very severe pain was noted by 3% of patients.The degree of expression of pain syndrome during PDT depends on the incidence of a lesion, histological form of tumor, and method of anesthesia. NSAID alone, or in combination with an opioid analgesic, allows effective control of pain syndrome in PDT of basal cell skin cancer in 89%, in PDT of squamous cell skin cancer in 66% of observations. Nerve block anesthesia allows stoping pain syndrome during PDT of oropharyngeal tumors.