Voice rehabilitation after total laryngectomy using the Newvox voice prosthesis. 2007

L Traissac, and G Chene, and F Devars, and Th Houliat, and I Essalki, and H Bekhar, and A Rousseau
Institut Georges Portmann, 114 avenue d'Arès, 33074 Bordeaux, France. traissac.1@wanadoo.fr

OBJECTIVE To evaluate the anatomy, as well as the probability of restoring voice (study of the methods of vocal recovery) with the Newvox voice prosthesis. METHODS This study relates to 225 patients having undergone a total laryngectomy and a Newvox voice prosthesis (one or more prosthesis) between April 1979 and November 2003. All the cases were followed up for 2 years. During evolution the complications were noted. All the valves removed were sent for microbiological analysis, including culture. The Statistical Analysis were carried out on the cohort of patients defined as having benefited from one or more voice prostheses after undergoing total laryngectomy. The lifespan of the implants has been described by the median duration (corresponding to the duration above which 50% of the implants lasted) the first quartile (corresponding to the duration above which 75% of the implants lasted) and the third quartile (corresponding to the duration above which 25% of the implants lasted). RESULTS No infection by candida albicans was found. Complete removal of the Newvox voice prosthesis for local problems was necessary only in 20 cases (8.9% of the cases). The general lifespan (on 225 patients) of the 1st implant corresponded to a median of 252 days (8.4 months) with a first quartile of 452 days (1.2 year). The statistical analysis of the lifespan of the Newvox voice prosthesis made it possible to study the impact of radiotherapy on the quality of the results. The time to onset of satisfactory phonation was studied: The general median (time above which includes 50% of the patients) was three weeks. After two weeks, 25% of the patients obtain a satisfactory voice. CONCLUSIONS On the whole, out of 185 documented cases, a satisfactory voice was obtained in 84% of patients, either by the voice prosthesis or by oesophageal voice. The absence of infection by candida albicans of the Newvox voice prosthesis is one of the factors which probably account for it being so well tolerated and having a significantly longer lifespan compared with other prostheses.

UI MeSH Term Description Entries
D007825 Laryngectomy Total or partial excision of the larynx. Laryngectomies
D007831 Larynx, Artificial A device, activated electronically or by expired pulmonary air, which simulates laryngeal activity and enables a laryngectomized person to speak. Examples of the pneumatic mechanical device are the Tokyo and Van Hunen artificial larynges. Electronic devices include the Western Electric electrolarynx, Tait oral vibrator, Cooper-Rand electrolarynx and the Ticchioni pipe. Artificial Larynx,Laryngeal Prosthesis,Voice Prosthesis,Artificial Larynges,Laryngeal Prostheses,Larynges, Artificial,Prostheses, Laryngeal,Prostheses, Voice,Prosthesis, Laryngeal,Prosthesis, Voice,Voice Prostheses
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010699 Phonation The process of producing vocal sounds by means of VOCAL CORDS vibrating in an expiratory blast of air. Phonations
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011474 Prosthesis Design The plan and delineation of prostheses in general or a specific prosthesis. Design, Prosthesis,Designs, Prosthesis,Prosthesis Designs
D002176 Candida albicans A unicellular budding fungus which is the principal pathogenic species causing CANDIDIASIS (moniliasis). Candida albicans var. stellatoidea,Candida stellatoidea,Dematium albicans,Monilia albicans,Myceloblastanon albicans,Mycotorula albicans,Parasaccharomyces albicans,Procandida albicans,Procandida stellatoidea,Saccharomyces albicans,Syringospora albicans
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

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