Biofilm assessment on voice prosthesis used for vocal rehabilitation in laryngectomized patients

Abstract

Background. Voice rehabilitation in patients undergoing total laryngectomy is fundamental for the social reinsertion of the patient. The gold standard to fulfill this objective is the implantation of a voice prosthesis (VP). The main limitation of VP use is the blockage with fluids and deterioration due to biofilm colonization, which leads to frequent replacements. Objectives. The purpose of the study is to identify the microorganisms that develop within the biofilm colonizing the collected VPs surfaces and the implantation situ and to determine whether that biofilm formation is the main reason for deterioration of VP proper function, leading to frequent replacements of VP. Material and methods. In our retrospective observational study we assessed the biofilm composition of 41 dysfunctional VP from 10 laryngectomized patients by collecting samples for microbiologic tests. The morphology of the biofilm was also observed using scanning electron microscopy, a precious tool for providing an extensive understanding of the microbial colonizing the behavior of the medical device. Outcomes. The microbiologic evaluation revealed a complex, mixed bacterial-fungal multispecies composition and the average time of exploitation for each VP was established. Deterioration of the silicone properties contributes to a large extent to the malfunction of VP. Conclusions. Further research in the medical engineering field and innovative approaches are expected to improve the device lifespan, by proving anti-biofilm properties and thus enhancing the quality of life for laryngectomized patients.