Voice rehabilitation after total laryngectomy using the Newvox voice prosthesis.
OBJECTIVE
To evaluate the anatomy, as well as the probability of restoring voice (study of the methods of vocal recovery) with the Newvox voice prosthesis.


METHODS
This study relates to 225 patients having undergone a total laryngectomy and a Newvox voice prosthesis (one or more prosthesis) between April 1979 and November 2003. All the cases were followed up for 2 years. During evolution the complications were noted. All the valves removed were sent for microbiological analysis, including culture. The Statistical Analysis were carried out on the cohort of patients defined as having benefited from one or more voice prostheses after undergoing total laryngectomy. The lifespan of the implants has been described by the median duration (corresponding to the duration above which 50% of the implants lasted) the first quartile (corresponding to the duration above which 75% of the implants lasted) and the third quartile (corresponding to the duration above which 25% of the implants lasted).


RESULTS
No infection by candida albicans was found. Complete removal of the Newvox voice prosthesis for local problems was necessary only in 20 cases (8.9% of the cases). The general lifespan (on 225 patients) of the 1st implant corresponded to a median of 252 days (8.4 months) with a first quartile of 452 days (1.2 year). The statistical analysis of the lifespan of the Newvox voice prosthesis made it possible to study the impact of radiotherapy on the quality of the results. The time to onset of satisfactory phonation was studied: The general median (time above which includes 50% of the patients) was three weeks. After two weeks, 25% of the patients obtain a satisfactory voice.


CONCLUSIONS
On the whole, out of 185 documented cases, a satisfactory voice was obtained in 84% of patients, either by the voice prosthesis or by oesophageal voice. The absence of infection by candida albicans of the Newvox voice prosthesis is one of the factors which probably account for it being so well tolerated and having a significantly longer lifespan compared with other prostheses.
Traissac
L
L
Institut Georges Portmann, 114 avenue d'Arès, 33074 Bordeaux, France. traissac.1@wanadoo.fr
Chene
G
G
Devars
F
F
Houliat
Th
T
Essalki
I
I
Bekhar
H
H
Rousseau
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002176:Candida albicans / Q000302:isolation & purification; D015331:Cohort Studies; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007825:Laryngectomy / Q000534:rehabilitation*; D007831:Larynx, Artificial / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D010699:Phonation / Q000502:physiology; D011183:Postoperative Complications; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D013072:Speech, Esophageal; D016019:Survival Analysis; D013997:Time Factors; D014831:Voice / Q000502:physiology; D014834:Voice Training