Klinische Anwendung einer Stimmprothese mit silberoxidhaltigem Ventil (Blom-Singer® Advantage) - Biofilmresistenz, Prothesenverweildauer und Indikation

Abstract

Using a voice prosthesis with a valve containing silver oxide can normalize and even increase the in-situ lifetime in patients with frequent changing procedures caused by fungal growth on the valve. Therefore we recommend the use of this type of voice prosthesis for those patients as reduction of costs and effort results.

Are modern voice prostheses better? A lifetime comparison of 749 voice prostheses

“…Comparison with results for the Provox ActiValve (median 291 days, p  < 0.001), shows a markedly shorter device life which is in concordance with its lower valve opening pressure and price. The device life of the Blom-Singer Dual Valve in our study also seems to be somewhat lower than the device life reported in previous investigations with the Blom-Singer ® Advantage (Kress: mean 101, median 87 days, Leder: mean 118–168 days) [7, 8]. …”

“…Due to patient comfort, safety and economical aspects, in the past years, several voice prostheses with additional features intended to prolong device life have become available. The Blom-Singer Advantage with a valve flap containing 7 % of silveroxide for patients with premature device failure due to biofilm formation colonisation [7, 8] and the Blom-Singer Dual Valve that incorporates two valve flaps containing silveroxide in the shaft of the device (no clinical data are currently available for this device), and the Provox ActiValve in which the valve flap and valve seat are constructed out of fluoroplastic and valve flap closure is supported by magnets for patients with early device failure due to biofilm formation and/or underpressure in the oesophagus during swallowing and/or inhalation [9]. In addition to these design changes, newer voice prostheses (Blom-Singer Dual Valve, Provox Vega and ActiValve) have also been found to have more defined opening pressures, which may lead to differences in device life [10].…”

“…The device life of the Provox ActiValve has been shown to be substantially longer than that of the traditional indwelling voice prostheses [9, 17, 18]. Also the Blom-Singer Advantage (model with hard valve assembly) has been shown to have a longer device life in selected patients [7, 8]. Published results regarding the device life of the Provox Vega have mainly covered short observation periods and were found to be similar to the device life of Provox2 [15, 16].…”

Comparison of biofilm formation on new Phonax and Provox 2 voice prostheses—A pilot study

“…Various attempts have been made to extend device lifetime and to improve material resistance of voice prostheses to yeasts and bacteria: surface treatments with active agents, alteration of surface properties by laser, and admixture of silver oxide into the silicone material 1–6. Various valve designs, such as the hinged valve flap (Provox 1, Provox 2, Provox Activalve), the slit valve type (Groningen Button), the tripod‐ball valve type (Voicemaster), and even valveless design (Nijdam) have been used in prosthesis construction.…”

Tracheostomy cannulas and voice prosthesis

“…Blom and Singer developed advantage tracheoesophageal voice prosthesis with modified flanges and a valve flap that is covered with 7% silver oxide in order to avoid candida community. Leder et al and Kress et al evaluated a longer duration of those voice prosthesis in comparison to the classic Blom-Singer voice prostheses [168], [169]. …”