Provox 2 use for voice restoration after total laryngectomy

Abstract

This study aims to determine the problems of patients applied provox 2 voice prosthesis for speech rehabilitation with their prosthesis and our treatment modalities to increase the quality of life of these patients. A total of 210 patients (180 males, 30 females; mean age 58±11.9 years; range 37 to 83 years) who underwent total laryngectomy, applied and changed provox 2 voice prosthesis for voice restoration were included in the study. For speech restoration of the patients with a primary (intraoperative) and secondary (postoperative) tracheoesophageal fistula was opened. In the 15th postoperative day, provox 2 voice prosthesis was placed to approximately 0.5 cm inferior and midline fistula line of the tracheostoma. The patients underwent speech exercises. The mean change time of prosthesis was 7.5 months (range 1 to 48 months). Fungal colonization was detected in 141 patients (66%) who had voice prostheses. Granulation tissue developed around the voice prosthesis in 30 patients (14%), three patients (1%) swallowed their voice prosthesis, tracheoesophageal fistula width remained permanently in two patients (1%), and these patients were abandoned to use their voice prosthesis. Mediastinitis occurred in one patient (1%). Due to several reasons such as success of high speech despite of complications and being easy to fight with these complications, provox voice prosthesis is an effective method to use for voice restoration.