Voice restoration and long-term progress in voice rehabilitation using the Provox2® voice prosthesis after total laryngectomy

Abstract

From January 2000 to December 2008, we conducted voice rehabilitation using the Provox2® voice prosthesis in 40 total-laryngectomy subjects. Of these, 36 attained restoration of 90.0%. Mean maximum phonation time (MPT) was 14.5s, ranging from 8 to 28s. MPT was not influenced by age, radiotherapy use, primary tumor site, or reconstructive surgery use. Voice prosthesis replacement averaged 25 weeks (5.8 months), ranging from 9 to 74 weeks. Complications occurred in 16 caces (40.0%), mainly granulation tissue formation and prosthesis-site infection, but also aspiration pneumonia, prosthesis-site salivary leakage, inability to replace the prosthesis, tracheomalacia, and foreign bodies in the trachea. Management rather than medical problems included cost, frequent hospital visits, and refusal or lack of motivation to use a prosthesis. The Provox2* voice prosthesis speech provides a higher rate of speech restoration, longer phonatory time, and better intelligibility. Management problems, however, require that we work to understand subjects' living environments and family situations better for evaluating Provox2* voice prosthesis indication more effectively.