Surgical voice rehabilitation performed by means of voice prosthesis post laryngectomy

Abstract

Introduction. In 1972, in Poland, Professor Erwin Mozolewski presented a pioneering thesis concerning the creation of intubated voice fistula in a group of 24 patients. It was undoubtedly the prototype of today’s voice prosthesis. Materials and method. The study involved 33 men after total laryngectomy due to advanced squamous cell carcinoma, treated in the Otolaryngology Ward of the District Hospital in Skarżysko-Kamienna between the years 2012–2017, who were implanted with a voice prosthesis Provox II and Provox Vega. Results. During the analyzed period, 127 voice prosthesis were replaced in 33 patients. This paper focuses on complications connected with the implantation of voice prosthesis. The most common reason for replacement of a voice prosthesis was fluid leakage through the voice prosthesis channel – 95 cases. Spontaneous prolapse of the voice prosthesis occurred in 11 patients, and after re-insertion of the prosthesis, the correct fistula voice was obtained. The voice prosthesis was replaced due to difficulty in creating the prosthetic speech in 8 patients. A much more serious complication is the occurrence of leakage around the voice prosthesis. In the examined group, leakage around the prosthesis occurred in 5 patients. An inflammatory plaque was formed around the prosthesis, which was removed in case of significant prosthetic cover or at the request of an alarmed patient – in 4 patients. The prosthesis protruded and rotated in the trachea and hung on a fragment of mucous membrane of the trachea in 1 patient.