Therapy of periprosthetical leakage with tissue augmentation using Bioplastique around the implanted voice prosthesis.
Having a voice prosthesis provides a good possibility for speech rehabilitation after total laryngectomy has been performed, especially if common complications such as leakage around the valve can be reduced effectively. The early applications of a voice prosthesis-which was originally invented and applied by Mozolewski in 1972, was further developed by Blom and Singer and became an internationally available implantable instrument by 1980- already made clear not only the typical benefits, but also the complications, such as possible leakage around the implanted valve. Remacle proposed the injection of collagen into the surrounding tissues in order to stop leakage. Knowing that collagen is usually resorbed as time goes by, new substances that can be tolerated by human tissues must be found. This article reports the experiences of the authors in the search for such an injectable material that cannot be resorbed and does not migrate. In order to solve the above-mentioned problem, Lichtenberger introduced the injection of Bioplastique into the perivalvular tissues. This delivered the best results ever achieved in this field at our department. During the past 2 years, Bioplastique augmentation was performed for seven laryngectomized and speech-rehabilitated patients in order to reduce periprosthetical leakage. All procedures were successful in terms of either eliminating or reducing the leakage, and also the non-resorbable property of Bioplastique has been proven.
Department of Otorhinolaryngology and Head and Neck Surgery, Szent Rokus Hospital, Gyulai Pal utca 2, 1085, Budapest, Hungary. orl.rokus@mailbox.hu
B B
BB
Lorincz
G
G
Lichtenberger
A
A
Bihari
J
J
Falvai
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery; D007825:Laryngectomy; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D011108:Polymers / Q000008:administration & dosage; D011182:Postoperative Care; D011475:Prosthesis Failure; D019919:Prosthesis Implantation; D011879:Radiotherapy Dosage; D014138:Tracheoesophageal Fistula / Q000601:surgery*
C068018:Bioplastique; D011108:Polymers