Abstract
The aim of the study was to compare device life of more recent indwelling voice prostheses Provox Vega and Blom-Singer Dual Valve to device life of well-known standard devices (Provox 2, Blom-Singer Classic). In a prospective, non-randomised study, device life of Blom-Singer Classic, Blom-Singer Dual Valve, Provox2, Provox Vega and Provox ActiValve voice prostheses was recorded in a group of 102 laryngectomised patients. In total 749 voice prosthesis were included. Average overall life time was 108 days, median 74 days. The prosthesis with the longest dwell time was the Provox ActiValve (median 291 days). Provox Vega had longer device life compared with Provox2 (median 92 days vs 66 days; p = 0.006) and compared with Blom-Singer Classic (median 92 days vs 69 days; p = 0.004). In conclusion, device lifetimes of Provox Vega and ActiValve were better than those of Provox2 and the Blom-Singer Classic. New voice prostheses, with a defined valve opening pressure (Provox Vega, Provox ActiValve, Blom-Singer Dual Valve) had longer lifetimes than prostheses without a defined opening pressure (Blom-Singer Classic and Provox 2).
Highlights
In 1982, the first indwelling voice prosthesis, the ‘‘Groningen Button’’ was introduced [1]
We have provided patients a Provox ActiValve when their voice prosthesis three times in a row had a life of 40 days or less, the shaft length of the prosthesis was always the same and there was no trachea-oesophageal (TE) puncture pathology
The prosthesis with the longest dwell time was the Provox ActiValve; this device appeared to have at least three times longer lifetimes compared to the other devices, and its device life time was significantly longer than any of the other standard voice prostheses (P \ 0.0001)
Summary
In 1982, the first indwelling voice prosthesis, the ‘‘Groningen Button’’ was introduced [1]. Disadvantages of the indwelling concept are the need for a physician or a speech language pathologist (SLP) to change the voice prostheses and the need for a placement tool. The device life of indwelling voice prostheses is largely dependent on patients and prosthesis factors (e.g. speaking habits, diet, biofilm resistance, underpressure, valve features) and cannot be improved by cleaning strategies as they are not cleaned on a daily basis similar to nonindwelling devices. In Germany indwelling voice prostheses with an anterograde insertion method and a rational cost/lifetime ratio became standard devices (Provox 2, Blom-Singer Classic). Safety and economical aspects, in the past years, several voice prostheses with additional features intended to prolong device life have
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