[Analysis of complications after surgical voice and speech rehabilitation in laryngectomized patients. Problems related to implantation and change of voice prosthesis].
BACKGROUND
Surgical rehabilitation of voice and speech, with implantation of Provox 2 voice prosthesis is becoming a standard procedure in Poland in the last few years. Still some opinions are raised, considering the potential risk of complications, particularly, when tracheo-esophageal puncture is finally located in the irradiated tissue.


OBJECTIVE
The assessment of safety, and analysis of complication encountered with tracheo-esophageal puncture, and implantation of voice prosthesis.


METHODS
The 106 cases of patients treated with mentioned above method. The primary implantation was performed in 73 (68,9%) cases; the secondary implantation in 33 (31,1%). The 85 (80,2%) patients received radiotherapy before, or after implantation. In the analyzed period (2002-2004) apart of 106 implantations, the replacement of 132 prostheses was performed.


RESULTS
There was only one, potentially life-threatening complication recorded in the analyzed group of 106 patients--inhalation of prosthesis to tracheo-bronchial tree. The most common complications directly related to implantation were: infection in the place of created fistula after secondary implantation 4/33(12,1%), and spontaneous partial extrusion of prosthesis with occlusion of created fistula tract 8/106 (7,5%). The average lifetime of prosthesis in place, was 9,8 months in irradiated field, and 9,7 months in patients who did not received radiotherapy.


CONCLUSIONS
Surgical rehabilitation of voice and speech, with implantation of vocal prosthesis is safe and reliable procedure. The radiotherapy applied before or after creation of tracheo-esophageal fistula is not a contra indication for this method. Generally low rate of complications is similar in both groups--who does received or not received radiotherapy. Also the stability of implanted prostheses were similar in both groups.
Bień
Stanisław
S
Dział Otolaryngologii Chirurgii Głowy i Szyi Swietokrzyskiego Centrum Onkologii w Kielcach.
Okła
Sławomir
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery; D007825:Laryngectomy / Q000534:rehabilitation*; D007831:Larynx, Artificial / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000534:rehabilitation*; D011474:Prosthesis Design / Q000009:adverse effects; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000009:adverse effects*; D012092:Replantation; D013070:Speech Therapy / Q000379:methods*; D014138:Tracheoesophageal Fistula / Q000534:rehabilitation*; D014833:Voice Quality; D014834:Voice Training