title: Prevention of voice prosthesis biofilms: current scenario and future trends in prolonging prosthesis lifetime.
abstract: Voice rehabilitation after a total laryngectomy is an important requisite for patients' rehabilitation. Oesophageal speech using tracheo-oesophageal-valved prostheses is now considered the state-of-art in postlaryngectomy voice rehabilitation. One of the major drawbacks of voice prostheses is their limited device lifetime. This is due to the deterioration of the silicone rubber material by different bacterial and yeast species, which are organised in the form of a biofilm resulting in internal leakage, increased airflow resistance, impeding speech, respiration and swallowing. The use of antimicrobials though easily applicable is associated with development of resistance if used on long-term basis. Other techniques in the form of modification of physicochemical properties of the silicon surface or covalent binding of antimicrobial agents to the silicon surface have been employed. This article reviews the different strategies investigated until now and the future trends in preventing biofilm formation for prolonging the lifetime of the silicon voice prostheses. Data was collected by conducting a computer aided search of the MED-LINE and PUBMED databases, supplemented by hand searches of key journals. Over 35 articles in the last two decades on the topic have been reviewed out of which 27 were found to be of relevant value for this article.
authors.affiliation: Department of ENT and Head & Neck Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai 400008.
authors.forename: Sushail I
authors.initials: SI
authors.lastname: Sayed
authors.forename: Sourav
authors.initials: S
authors.lastname: Datta
authors.forename: Nitin
authors.initials: N
authors.lastname: Deore
authors.forename: Rehan A
authors.initials: RA
authors.lastname: Kazi
authors.forename: Mohan V
authors.initials: MV
authors.lastname: Jagade
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D001672:Biocompatible Materials / Q000627:therapeutic use; D018441:Biofilms / Q000187:drug effects*; D002175:Candida / Q000254:growth & development / Q000302:isolation & purification; D019544:Equipment Failure Analysis; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects / Q000534:rehabilitation; D007831:Larynx, Artificial / Q000009:adverse effects*; D011183:Postoperative Complications / Q000517:prevention & control*; D011474:Prosthesis Design / Q000379:methods / Q000639:trends; D011475:Prosthesis Failure / Q000187:drug effects; D019919:Prosthesis Implantation / Q000534:rehabilitation; D016459:Prosthesis-Related Infections / Q000382:microbiology; D012826:Silicone Elastomers; D013071:Speech, Alaryngeal / Q000295:instrumentation / Q000379:methods; D013291:Streptococcus / Q000254:growth & development / Q000302:isolation & purification; D013501:Surface-Active Agents / Q000627:therapeutic use
chemical_list: D000890:Anti-Infective Agents; D001672:Biocompatible Materials; D012826:Silicone Elastomers; D013501:Surface-Active Agents