title: [Examination of biofilm related material deterioration on 20 PROVOX2 voice prostheses by scanning electron microscopy].
abstract: BACKGROUND
  Mechanical impairment of valve function by biofilms is considered to cause loss of function of voice prostheses in laryngectomized patients. Material deterioration and infiltrative growth of Candida associated biofilms have already been observed on Groningen Buttons. Goal of the study was the examination of biofilm formation and material damages on PROVOX2 voice prostheses.
  
  
  METHODS
  20 PROVOX2 voice prostheses were withdrawn from 17 laryngectomized patients due to aspiration (mean in-vivo time: 118 d, median 98 d). Microbial spectrum, colonization patterns and morphologies of prosthesis damage were assessed using standard microbiologic procedures and scanning electron microscopy.
  
  
  RESULTS
  Biofilm with various growth patterns predominantly adhered to the esophageal parts of the prostheses. Microbiologic findings showed Candida species as main colonisers on esophageal surfaces. Different morphologies of surface alteration and material infiltration of the polymer material were identified on 8 prostheses with 35 d of in-vivo time minimum.
  
  
  CONCLUSIONS
  Valve dysfunction of PROVOX2 voice prostheses can be attributed to biofilm formation on esophageal surfaces and edges of the valve flap and seating. The identified morphologies of material damage and invasive growth indicate towards lytic processes of the polymer material due to Candida associated biofilms.
authors.affiliation: Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Wien. matthias.leonhard@meduniwien.ac.at
authors.forename: M
authors.initials: M
authors.lastname: Leonhard
authors.forename: A
authors.initials: A
authors.lastname: Reumüller
authors.forename: D
authors.initials: D
authors.lastname: Moser
authors.forename: W
authors.initials: W
authors.lastname: Bigenzahn
authors.forename: B
authors.initials: B
authors.lastname: Schneider-Stickler
mesh_terms: D000368:Aged; D018441:Biofilms / Q000254:growth & development*; D002175:Candida / Q000254:growth & development* / Q000648:ultrastructure; D002176:Candida albicans / Q000254:growth & development / Q000648:ultrastructure; D003114:Colony-Forming Units Assay; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007825:Laryngectomy; D007831:Larynx, Artificial / Q000382:microbiology*; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000473:pathology; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology; D011474:Prosthesis Design