Causes and indwelling times of multiple mice prosthesis replacements in patients after total laryngectomy — analysis of 184 replacements in 42 patients
Journal Title: Otolaryngologia Polska - Year 2012, Vol 66, Issue 5
Abstract
Introduction: Implantation of the indwelling voice prosthesis has become the preferred method of voice rehabilitation after total laryngectomy. Frequent prosthesis dysfunction remains the major problem. Aim: Analysis of the indwelling time and indications for multiple voice prosthesis replacements. Methods: Forty two patients after total laryngec-tomy due to laryngeal cancer (6 women and 36 men, mean age 62.1 + 6.7 years) were included. 184 voice prosthesis replacements were analyzed (1271 patient-months). Results: Mean time between replacements was 260 + 150 days. The indwelling time decreased from 267 days to the first replacement to 100-160 days at eighth and subsequent exchanges (p < 0.01). Most frequent indications for replacement were leakage of fluids through the prosthesis, phonation problems caused by mucosal overgrowth around the prosthesis, inaccurate sizing, deformation, and spontaneous extrusion. The lifetime of voice prostheses was positively correlated with patients' age. Mycological culture of the smear taken from tracheoesophageal fistula at first replacement was positive in 34/41 cases, at the second in 29/31 cases, the third in 29/31, and at the fourth and subsequent replacements in all specimens. Most patients indicated the following factors as possible causes of a shortened lifetime of the prosthesis: use of alcohol and coffee (34% of responders), inappropriate dietary habits (sweets and tough foodstuff - 17%), cleaning of voice prosthesis discordant with the recommendations of the manufacturer (14%). Conclusions: Although our results confirm common indications for voice prosthesis replacement we also showed that the time between exchanges is gradually getting shorter. This observation could have implications for the current reimbursement practices.
Authors and Affiliations
Joanna Zimmer-Nowicka, Alina Morawiec-Sztandera
Keywords
Related Articles
- EP ID EP52088
- DOI -
- Views 97
- Downloads 0
Analiza uwarunkowań genetycznych wrodzonej naczyniakowatości krwotocznej choroby Rendu-Oslera-Webera – doniesienia wstępne
Introduction. Hereditary haemorrhagic telangiectasia (HHT) known also as Rendu-Osler-Weber syndrome is an autosomal dominant disorder characterized by localized angiodysplasia due to mutations in ENG (endoglin, 9q34.1) o...
Universal electrogustometer EG-2
SUMMARY Electrogustometry is a method for taste diagnosis and measurement. The EG-2 project is being developed in cooperation between Warsaw University of Technology and Military Institute of Medicine in Warsaw. The devi...
Zastosowanie NBI – wąskopasmowej endoskopii lupowej do oceny krtani
Wąskopasmowa endoskopia lupowa (NBI) poprzez wizualizację naczyń nabłonka ułatwia wykrywanie zmian przednowotworowych, nowotworowych i przerostowych, np. brodawczaków krtani. Technologia NBI oparta jest na modyfikacji św...
Ocena kieszonek retrakcyjnych i sposoby postępowania terapeutycznego
Niniejsza publikacja ma na celu dokonanie przeglądu typów kieszonek retrakcyjnych u dorosłych i dzieci, patogene¬zy ich powstawania, powiązanych czynników ryzyka oraz potencjalnych metod ich zapobiegania i leczenia. Znac...
Laryngeal leiomyosarcoma in clinical cases of the Otolaryngology Departament in The University Hospital of Krakow
Introduction. Leiomyosarcoma is a malign neoplasm coming from the non-epithelial tissue. It rarely developes in the larynx. 0,5–1% of all of the neoplasm of the larynx is leiomyosarcoma. It usually developes in the age o...