The Provox™ voice prosthesis andCandida albicansgrowth: a preliminary report of clinical, mycological and scanning electron microscopic assessment

Abstract

Provox™ voice prostheses are low-resistance speech valves available since 1990 for post-laryngectomy voice rehabilitation.Candida spp. mycelial growth has always been a major problem in all prosthetic valves causing leakage and limiting valve life. We found that the Provox™ new valves were not exempt from the old problem. We performed a preliminary clinical, mycological and scanning electron microscopic assessment ofCandida spp. growth on these valves. In contrast to studies done with other valves we found that theCandidamycelium on these new valves was a surface colony rather than growing into the valve substance, thus it might be feasible to control the mycelial growth by either mechanical cleansing or by using topical anti-fungal agents.

In Situ Lifetime, Causes for Replacement, and Complications of the ProvoxTMVoice Prosthesis

“…Causes for replacement in our series were salivary leakage through the prosthesis valve, salivary leakage around the prosthesis, deterioration of the prosthesis, and increased airflow resistance with excessive crusting in 33%, 27%, 24%, and 16% of cases, respectively. Deterioration of the Provox VP has been linked to fungal colonization 12 . Unfortunately topical antifungal therapy has been inconclusive and difficult to maintain long‐term 13 …”

Colonization of Voice Prostheses by Albicans and Non‐Albicans Candida Species

“…Replacement of the voice prosthesis is necessary as soon as leakage occurs after microbial colonization or physical deterioration. 3–8 …”

Candida biofilms associated with CVC and medical devices

“…In an early study, Natarajan et al. [34] used SEM to show the presence of blastoconidial and pseudohyphal forms of C. albicans on Provox voice prosthesis. More recently, Leonhard et al.…”