The long-term indwelling tracheoesophageal prosthesis for alaryngeal voice rehabilitation.
OBJECTIVE
To analyze the initial experience at Oregon Health Sciences University, Portland, with the use of long-term indwelling tracheoesophageal voice prostheses.


METHODS
Retrospective case series.


METHODS
Tertiary referral academic medical center.


METHODS
Thirty patients undergoing speech rehabilitation after laryngectomy during a period of 18 months.


METHODS
Insertion of a long-term indwelling tracheoesophageal voice prosthesis.


METHODS
Duration of use, complications.


RESULTS
The mean duration of placement for a single prosthesis was 4.9 months (148 days), with a range of 14 to 330 days. Sixteen of the 30 patients encountered problems with leakage because of fungal colonization, the majority of which (15 of 16 cases) were solved with either oral or topical application of nystatin. Size matching in terms of prosthesis length and tract length was critical, and problems of this nature were encountered in 11 of 30 patients. The incorporation of a second system of prostheses that offered an increased number of size options solved these problems in all of these patients. Ultimately, 27 of 30 patients were able to successfully wear these prostheses.


CONCLUSIONS
The indwelling tracheoesophageal voice prosthesis offers patients all the advantages of tracheoesophageal speech rehabilitation after laryngectomy without the inconvenience of frequent prosthesis changes. With careful attention to the details of fitting and care, it can be worn by the majority of patients successfully.
Graville
D
D
Department of Speech and Language Pathology, Oregon Health Sciences University, Portland 97201, USA.
Gross
N
N
Andersen
P
P
Everts
E
E
Cohen
J
J
D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy; D007831:Larynx, Artificial; D011474:Prosthesis Design; D012189:Retrospective Studies; D013071:Speech, Alaryngeal; D013997:Time Factors; D016896:Treatment Outcome