Long-term performance of indwelling tracheoesophageal speaking valves in Chinese patients undergoing laryngectomy.
OBJECTIVE
To assess the use of indwelling tracheoesophageal speaking valves in Chinese patients undergoing laryngectomy, to identify the clinicopathologic factors for favorable outcome, and to evaluate the factors that determine prosthesis lifetime.


METHODS
Retrospective review.


METHODS
Tertiary care institution.


METHODS
Sixty consecutive patients with total laryngectomy were included. All had indwelling tracheoesophageal speaking valves for voice restoration.


METHODS
Anterograde replacement of voice prosthesis in case of failure of functional speech production or leakage of saliva.


METHODS
Incidence of successful tracheoesophageal speech rehabilitation for daily communication, influence of different clinicopathologic factors on the outcome, and prosthesis lifetime and its relationship to different clinicopathologic factors.


RESULTS
The success rate of speech rehabilitation was 78%. Age younger than 60 years was the only clinicopathologic factor associated with successful speech rehabilitation (P = .04, Fisher exact test). The median device lifetime was 8.2 months. Both age of 60 years or older and the use of subsequent prosthetic valves were identified as risk factors for valve failure on univariate analysis (n = 192; log-rank test; P = .02 and P = .03, respectively), with age of 60 years or older as the only risk factor that reduced the device lifetime in the Cox proportional hazards model (P = .03; relative hazard ratio, 1.5; 95% confidence interval, 1.1-2.4).


CONCLUSIONS
Our success rate in using indwelling tracheoesophageal speaking valves was comparable to that reported in the Western literature. The median device lifetime of 8.2 months was satisfactory. Patient age was found to be a significant predictor of successful tracheoesophageal speech rehabilitation, with age of 60 years or more adversely affecting device lifetime.
Lam
Paul Kin-Yip
PK
Division of Otorhinolaryngology, Head & Neck Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong.
Ho
Wai-Kuen
WK
Ho
Ambrose Chung-Wai
AC
Ng
Raymond Wai-Man
RW
Yuen
Anthony Po Wing
AP
Wei
William Ignace
WI
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D004947:Esophagus / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000453:epidemiology / Q000534:rehabilitation / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000534:rehabilitation / Q000601:surgery; D007825:Laryngectomy; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology / Q000534:rehabilitation / Q000601:surgery; D011474:Prosthesis Design; D011677:Punctures; D012189:Retrospective Studies; D012307:Risk Factors; D013995:Time; D014062:Tongue Neoplasms / Q000453:epidemiology / Q000534:rehabilitation / Q000601:surgery; D014132:Trachea / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome