Aetiology of voice prosthesis' leakage after laryngectomy

Introduction:

Regaining the ability to speak after laryngectomy is a major issue in regards to the quality of life for affected patients. Voice prostheses have been reliable tools for a satisfactory communication in such cases. Nevertheless, frequent replacements of prostheses are burdening several patients. Therefore, a more accurate understanding of the mechanisms of (peri)prosthetic leakage is essential for an adequate patient follow-up care.

Methods:

We performed a retrospective analysis of clinical data regarding 58 patients who underwent laryngectomy between 2008 and 2013.

Results:

18 out of 58 patients had no voice prosthesis replacement after primary insertion e.g. due to early recurrent disease or other complications. For the remaining cohort, median device life was 235 days (57 to 927 days). Patients treated with adjuvant radiotherapy (RT) showed a significantly longer device life than patients, who underwent adjuvant radio-chemotherapy (RTC) (p = 0.002). This was not due to periprosthetic atrophy with change to a smaller prosthesis, which was observed in 17 patients (p = 0,538). However, patients who were treated with proton pump inhibitors due to gastroesophageal reflux disease (GERD) showed a significantly shortened device life (p = 0.04). Esophageal stenosis was observed in 17 cases with no influence on prostheses' device life or insufficiency.

Conclusions:

Adjuvant RCT seems to predispose to a shortened voice prosthesis' device life. Especially GERD is a major risk factor and should therefore effectively be treated after laryngectomy.

Publication History

Publication Date:
23 April 2019 (online)