Indwelling Tracheo-oesophageal Voice Prostheses Post-Laryngectomy in Sheffield, UK: A 6-Year Review

Abstract

The Groningen and Provox tracheo-oesophageal valve voice prostheses have been used in post-laryngectomy patients extensively in Sheffield since 1986 and 1990, respectively. To the present time a total of over 40 patients have made use of these devices, two thirds of whom underwent insertion at the time of laryngectomy. Prostheses were replaced under local or general anaesthesia if they were leaking or if phonation became increasingly difficult. Our experience with over 200 valves including the Groningen High Resistance, Groningen Low Resistance and Provox prostheses in this patient group is presented. We believe that the primary insertion of a low resistance prosthesis, either the Provox or Groningen Low Resistance device, is the method of choice in speech rehabilitation following laryngectomy.

The Influence of Radiotherapy on the Lifetime of Silicone Rubber Voice Prostheses in Laryngectomized Patients

“…A serious problem in laryngectomized patients with a voice prosthesis inserted is the limited lifetime of the prosthesis of approximately 3 to 4 months. 12 Voice prostheses become covered with a biofilm, composed of bacteria, yeasts, and their excreted organic matter, causing leakage of liquids or an increased airflow resistance resulting in replacement of the prosthesis. 13,14 Although replacement is a simple procedure carried out in the outpatient department, most patients experience replacements as unpleasant.…”

Comprehensive Rehabilitation after Total Laryngectomy Is More than Voice Alone

“…An indwelling voice prosthesis is not a permanent implant, but requires periodic replacement (on average after 4-5 months) [13,16,20]. Just like the surgical insertion, the replacement is also carried out with the special guide wire in a retrograde manner.…”

Secondary Shunt Procedure for Alaryngeal Patients in an Outpatient Clinic

“…Several voice prostheses have been developed, including four indwelling voice prostheses: the Groningen, Provox, Nijdam and Blom -Singer devices (1,3,4,15). Physicians in Japan, however, have only two choices of indwelling voice prostheses -the Groningen and Provox -and only the Groningen is covered by national health insurance.…”