title: [Early and late complications after implantation of the Provox 2 voice prosthesis in patients after total laryngectomy].
abstract: BACKGROUND
  Effective communication is an important element of social life. For a long time depravation of the capacity of such communication has been perceived as one of the most aggravating disabilities. It happens when the necessity to remove the larynx in patients with cancer appears. Contemporary methods of speech rehabilitation in patients after total laryngectomy create the possibility to communicate by three methods. One of them is generated speech with the use of voice prosthesis.
  
  
  METHODS
  The examination included group of 76 patients (7 women, 69 men) after total laryngectomy with implanted voice prosthesis Provox 2. All the patients were operated on at the Department of Otolaryngology CM UMK. The early and late complication after implantation of voice prosthesis was analyzed.
  
  
  RESULTS
  In our material we observed more frequentyly late complications. In 97.4% a leakage through or around the prosthesis was observed. In 35 cases we observed leakage through the wide tracheooesophagal fistula with good outcome due to spontaneusly contract of it after removal of the prosthesis. In four cases we used stitches above the fistula and in three patients we did tracheostomal plastic. The granulation tissue from the region of the fistula was removed in 11 patients. Spontaneous falling out of the prosthesis appeared in 6 cases. The late complications as tracheal immflamation, stricture of the oesophagus or occlusion of the fistula were less common.
  
  
  CONCLUSIONS
  The late complications after implantation of Provox 2 prosthesis are more common in this type of patients' rehabilitation. The leakage through or around the prosthesis required its exchange and generated additional medical costs, which should be reserved in medical insurance policies.
authors.affiliation: Katedra i Klinika Otolaryngologii i Onkologii Laryngologicznej Collegium Medicum w Bydgoszczy, Uniwersytetu Mikołaja Kopernika w Toruniu.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Wierzchowska
authors.forename: Paweł K
authors.initials: PK
authors.lastname: Burduk
mesh_terms: D000328:Adult; D000368:Aged; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D007831:Larynx, Artificial / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011044:Poland; D011183:Postoperative Complications / Q000534:rehabilitation*; D011474:Prosthesis Design / Q000009:adverse effects*; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000009:adverse effects*; D016896:Treatment Outcome; D014833:Voice Quality; D014834:Voice Training