Practical Management of Periprosthetic Leakage in Patients Rehabilitated With a Provox® 2 Voice Prosthesis After Total Laryngectomy

Friedlander, Eviatar; Martínez, Paloma Pinacho; Serafini, D; Martin-Oviedo, Carlos; Guirado, Tomás Martinez; Yurrita, Bartolomé Scola

doi:10.1016/j.otoeng.2015.12.003

Cited by 3 publications

(5 citation statements)

References 11 publications

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“…Depending on the severity of fistula, the management options ranges from conservative to invasive approaches. Collagen, autologous fat injection, injection of hyaluronic acid, use of a silastic wafer or a purse string suture can potentially help improve the seal around the prosthesis and prevent leakage [29,30]. Insertion of small bore nasogastric tube can be used to allow shrinkage of fistula in the interim period which is followed by a subsequent prosthesis reinsertion.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Factors Affecting the Longevity of Voice Prosthesis Following Total Laryngectomy with a Review of Literature

Khwajamohiuddin

2017

Indian J Surg Oncol

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Tracheoesophageal voice puncture (TEP) coupled with the use of voice prosthesis has been considered as the gold standard for speech rehabilitation in patients of advanced laryngeal/hypopharyngeal carcinomas, who have undergone a total laryngectomy with or without partial pharyngectomy. Although prosthetic voice rehabilitation is commonly practiced worldwide including India, there is a paucity of published Indian data, more so in the current era of organ conservation. This study included 60 laryngectomized patients with a prosthetic voice rehabilitation at a tertiary cancer center in South India between January 1, 2010 and December 31, 2013. Among the 60 patients, the primary site of cancer was the larynx in 43 patients and hypopharynx in the remaining 17. All patients had undergone a primary TEP insertion, 55 in the upfront setting and five in the salvage (post-radiation/chemo-radiation) setting. The ability to retain a successful trachea-esophageal speech on follow-up (median 15.5 months) in our series was around 82%. The mean device life of voice prosthesis in our patient cohort was 16 months. There was surprisingly no significant difference in the prosthesis device life on correlation with age, co-morbidities, habitat, literacy status, pre-operative tracheostomy, setting of surgery, and the extent of surgery. Our series has successfully demonstrated the safety and feasibility of using primary TEP coupled with the use of voice prosthesis for voice rehabilitation in properly selected and motivated patients of advanced laryngeal and hypopharyngeal carcinomas across all clinical settings. A mean device life of 16 months makes prosthetic voice rehabilitation, an attractive as well as a financially viable option for patients in a resource constrained setting.

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Section: Discussionmentioning

confidence: 99%

Analysis of Factors Affecting the Longevity of Voice Prosthesis Following Total Laryngectomy with a Review of Literature

Khwajamohiuddin

2017

Indian J Surg Oncol

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“…Cleaning is especially helpful after eating sticky foods or whenever one's voice is weak. 17 A prosthesis cleaning brush and flushing bulb are used in the cleaning process.…”

Section: Cleaning the Voice Prosthesis And Preventing Leakagementioning

confidence: 99%

“…Warm water works better than room temperature water in cleansing the prosthesis, probably because it dissolves the dry secretions and mucus and perhaps even flushes away (or even kills) some of the yeast colonies that had formed on the prosthesis. 17 Initially the mucus around the prosthesis should be cleaned using tweezers, preferably with rounded tips. Following that, the manufacturer-provided brush should be inserted into the prosthesis and twisted back and forth.…”

Section: Cleaning the Voice Prosthesis And Preventing Leakagementioning

confidence: 99%

Tracheoesophageal Voice Prosthesis Use and Maintenance in Laryngectomees

Brook

Goodman

2020

Int Arch Otorhinolaryngol

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Tracheoesophageal speech is the most common voicing method used by laryngectomees. This method requires the installation of tracheoesophageal prosthesis (TEP), which requires continuous maintenance to achieve optimal speaking abilities and prevent fluid leakage from the esophagus to the trachea. The present manuscript describes the available types of TEPs, the procedures used to maintain them, the causes for their failure due to fluid leakage, and the methods used for their prevention. Knowledge and understanding of these issues can assist the otolaryngologist in caring for laryngectomees who use tracheoesophageal speech.

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“…In these cases, the use of a more resistant prosthesis equipped with magnets is required. 13 By contrast, periprosthetic leakage represents a “real” long-term complication because of its demanding management, 14-17 one of the main causes of failure in VP rehabilitation and one of the reasons leading to fistula closure. 18…”

mentioning

confidence: 99%

“…In these cases, the use of a more resistant prosthesis equipped with magnets is required. 13 By contrast, periprosthetic leakage represents a ''real'' long-term complication because of its demanding management, [14][15][16][17] one of the main causes of failure in VP rehabilitation and one of the reasons leading to fistula closure. 18 Regarding periprosthetic leakage, a fairly extensive work on risk factors, therapy outcomes, and management algorithms is present in the literature.…”

mentioning

confidence: 99%

Periprosthetic Leakage in Tracheoesophageal Prosthesis: Proposal of a Standardized Therapeutic Algorithm

Parrilla¹,

Longobardi²,

Galli³

et al. 2021

Otolaryngol.--head neck surg.

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Objective Periprosthetic leakage represents the most demanding long-term complication in the voice prosthesis rehabilitation. The aim of this article is to discuss the various causes of periprosthetic leakage and to propose a systematic management algorithm. Study Design Retrospective cohort study. Setting Otolaryngology clinic of the University Polyclinic A. Gemelli–IRCCS Foundation. Methods The study included 115 patients with voice prosthesis who were treated from December 2014 to December 2019. All patients who experienced periprosthetic leakage were treated with the same step-by-step therapeutic approach until it was successful. Incidence, management, and success rate of every attempt are analyzed and discussed. Results Periprosthetic leakage was reported 330 times by 82 patients in 1374 clinic accesses. Radiotherapy, timing of tracheoesophageal puncture, and type of total laryngectomy (primary or salvage) did not influence the incidence of periprosthetic leakage. Salvage total laryngectomy increases the risk of more clinically relevant leakages. Conclusion By using a systematic algorithm with a step-by-step standardized approach, periprosthetic leakage management could become a less treacherous issue.

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Practical Management of Periprosthetic Leakage in Patients Rehabilitated With a Provox® 2 Voice Prosthesis After Total Laryngectomy

Cited by 3 publications

References 11 publications

Analysis of Factors Affecting the Longevity of Voice Prosthesis Following Total Laryngectomy with a Review of Literature

Analysis of Factors Affecting the Longevity of Voice Prosthesis Following Total Laryngectomy with a Review of Literature

Tracheoesophageal Voice Prosthesis Use and Maintenance in Laryngectomees

Periprosthetic Leakage in Tracheoesophageal Prosthesis: Proposal of a Standardized Therapeutic Algorithm

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