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Wu MP, Sullivan C, Deschler DG. Modified Technique for Retrograde Placement of the Tracheoesophageal Voice Prosthesis in the Office. Laryngoscope 2024. [PMID: 39054885 DOI: 10.1002/lary.31659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/18/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024]
Abstract
For total laryngectomy patients with tortuous tracheoesophageal puncture (TEP) tracts, anterograde placement of the voice prosthesis can be challenging. This article describes an updated and straightforward technique for in-office retrograde placement of the voice prosthesis in patients with such challenging TEP tracts. Laryngoscope, 2024.
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Affiliation(s)
- Michael P Wu
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Cody Sullivan
- Voice and Speech Laboratory, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Daniel G Deschler
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
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Kouka M, Beckmann L, Bitter T, Kaftan H, Böger D, Büntzel J, Müller A, Hoffmann K, Podzimek J, Pietschmann K, Ernst T, Guntinas-Lichius O. Oncological and functional outcome after laryngectomy for laryngeal and hypopharyngeal cancer: a population-based analysis in Germany from 2001 to 2020. Sci Rep 2024; 14:7761. [PMID: 38565603 PMCID: PMC10987613 DOI: 10.1038/s41598-024-58423-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 03/28/2024] [Indexed: 04/04/2024] Open
Abstract
Prognostic factors for overall survival (OS), percutaneous endoscopic gastrostomy (PEG) dependency, and long-term speech rehabilitation via voice prosthesis (VP) after laryngectomy for laryngeal or hypopharyngeal cancer were investigated in a retrospective population-based study in Thuringia, Germany. A total of 617 patients (68.7% larynx; hypopharynx; 31.3%; 93.7% men; median age 62 years; 66.0% stage IV) from 2001 to 2020 were included. Kaplan-Meier and Cox multivariable regression analyses were performed. 23.7% of patients received a PEG. 74.7% received a VP. Median OS was 131 months. Independent factors for lower OS were stage IV (compared to stage II; hazard ratio [HR] = 3.455; confidence interval [CI] 1.395-8.556) and laryngectomy for a recurrent disease (HR = 1.550; CI 1.078-2.228). Median time to PEG removal was 7 months. Prior partial surgery before laryngectomy showed a tendency for independent association for later PEG removal (HR = 1.959; CI 0.921-4.167). Postoperative aspiration needing treatment was an independent risk factor (HR = 2.679; CI 1.001-7.167) for later definitive VP removal. Laryngectomy continuously plays an important role in a curative daily routine treatment setting of advanced laryngeal or hypopharyngeal cancer in Germany. Long-term dependency on nutrition via PEG is an important issue, whereas use of VP is a stable long-term measure for voice rehabilitation.
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Affiliation(s)
- Mussab Kouka
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Louise Beckmann
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Thomas Bitter
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Holger Kaftan
- Department of Otorhinolaryngology, Helios-Klinikum Erfurt, Erfurt, Germany
| | - Daniel Böger
- Department of Otorhinolaryngology, SRH Zentralklinikum Suhl, Suhl, Germany
| | - Jens Büntzel
- Department of Otorhinolaryngology, Suedharzklinikum Nordhausen, Nordhausen, Germany
| | - Andreas Müller
- Department of Otorhinolaryngology, SRH Wald-Klinikum Gera, Gera, Germany
| | - Kerstin Hoffmann
- Department of Otorhinolaryngology, Sophien-Hufeland-Klinikum, Weimar, Germany
| | - Jiri Podzimek
- Department of Otorhinolaryngology, Klinikum Bad Salzungen, Bad Salzungen, Germany
| | - Klaus Pietschmann
- Department of Radiation Oncology, Jena University Hospital, Jena, Germany
| | - Thomas Ernst
- University Tumor Center, Jena University Hospital, Jena, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
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Iwai M, Ando S, Sato K. The process of reacquiring new vocalization in total laryngectomy patients with head and neck cancer: A qualitative study. Asia Pac J Oncol Nurs 2024; 11:100362. [PMID: 38433771 PMCID: PMC10904916 DOI: 10.1016/j.apjon.2023.100362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/03/2023] [Indexed: 03/05/2024] Open
Abstract
Objective Speech rehabilitation significantly contributes to the enhanced quality of life for patients who have undergone laryngectomy due to head and neck cancer. The initiation of tracheoesophageal speech early in the rehabilitation process has been associated with improved speech quality. Despite this, voice changes can carry a stigma due to communication challenges, even after successful voice restoration, potentially limiting the overall improvement in quality of life. Thus, our aim was to gain a profound understanding of the transition process from the selection to the adaptation of tracheoesophageal speech in patients with head and neck cancer. Methods Participants, who had undergone laryngectomy for head and neck cancer, were recruited from peer support groups in Japan, resulting in the identification of thirteen tracheoesophageal speakers. The data were analyzed using grounded theory methodology, incorporating open, axial, and selective coding. Semi-structured interviews delved into tracheoesophageal speakers' perceptions of their voices and the adaptive strategies employed for their preferred alternative communication methods. Results During the adaptation process, participants underscored the importance of communicating with their own voices. However, they also experienced anxiety about losing their natural voice, confronted the reality of living without a voice, and coped with their new voice. Eventually, participants came to recognize the changed voice as their own. Conclusions The personal conviction associated with the notion of "communicating with one's own voice" is integral to the adaptation process for patients with head and neck cancer who undergo laryngectomies and utilize tracheoesophageal speech. Some aspects of tracheoesophageal speech can evoke feelings of hopelessness, emphasizing the importance of comprehensive support for professional speech rehabilitation.
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Affiliation(s)
- Miyoko Iwai
- Nursing for Advanced Practice, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya City, Aichi, Japan
| | - Shoko Ando
- Department of Nursing, Ichinomiya Kenshin College, Ichinomiya City, Aichi, Japan
| | - Kazuki Sato
- Nursing for Advanced Practice, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya City, Aichi, Japan
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Pires RC, Gama RR, da Silveira Júnior PS, Teixeira FM, Santos CR, de Castro Capuzzo R. Analysis of durability and replacement of vocal prostheses in total laryngectomy patients at a head and neck surgery referral center. Eur Arch Otorhinolaryngol 2024; 281:351-357. [PMID: 37776343 DOI: 10.1007/s00405-023-08180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/07/2023] [Indexed: 10/02/2023]
Abstract
PURPOSE The use of tracheoesophageal prostheses has become the gold standard in vocal rehabilitation of patients undergoing total laryngectomy. However, this method also has limitations, such as the need for frequent replacement of prostheses due to leakage or other complications. We have designed a study to access the clinical profile of patients using tracheoesophageal prostheses as vocal rehabilitation after total laryngectomy and to determine the average rate of changes, as well as the main causes of prostheses replacement. METHODS A retrospective cohort study was performed based on patients who underwent rehabilitation with voice prostheses after total laryngectomy between 2008 and 2017. RESULTS The sample consisted of 93 patients and 432 vocal prostheses replacement events. The median change of prostheses per patient was 210.25 days, (range 57.33 to 651.50). The most frequent cause of prostheses replacement was leakage through the prostheses, 218 (50.46%). Lower level of education was associated to higher prostheses replacement rate. CONCLUSION The results of this study show that the median of prostheses durability is higher than that presented in the literature, the main cause of replacement was protheses leakage and that low educational level is associated to higher replacement rate.
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Affiliation(s)
- Rafael Cardoso Pires
- Head and Neck Surgery Department, Amazonia Cancer Hospital, Rodovia BR 364, Km 15, S/N, Área Rural, Porto Velho, Rondônia, Brazil.
| | - Ricardo Ribeiro Gama
- Head and Neck Surgery Department, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Paulo Sérgio da Silveira Júnior
- Head and Neck Surgery Department, Amazonia Cancer Hospital, Rodovia BR 364, Km 15, S/N, Área Rural, Porto Velho, Rondônia, Brazil
| | | | - Carlos Roberto Santos
- Head and Neck Surgery Department, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
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Mayo-Yáñez M, Cabo-Varela I, Calvo-Henríquez C, Chiesa-Estomba C, Herranz González-Botas J. Prevention of periprosthetic leakage with double flange voice prosthesis: a systematic review and management protocol proposal. LOGOP PHONIATR VOCO 2023; 48:129-136. [PMID: 35213274 DOI: 10.1080/14015439.2022.2042595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To conduct a systematic review of the use and results of the Provox®VegaTMXtraSealTM in the prevention of periprosthetic leakage and to propose a management protocol for this voice prosthesis. METHODS Systematic search based on the PRISMA Statement during February 2020. Keywords were double flange, periprosthetic leakage, voice prosthesis, and laryngectomy. RESULTS Four articles with 315 voice prosthesis (94 XtraSeal and 221 controls) in 55 patients were found. The XtraSeal mean duration was 114.28 ± 73.2 (CI 95%, 98.29-130.26) days compared to 102.98 ± 17.74 (CI 95%, 100.62-105.35) days of the control group. Out of 266 replacements, endoprosthetic leakage was the most frequent cause in both groups (62.41%). Periprosthetic leaks were less frequent in the XtraSeal (9.62%) than in the control group (22.43%). CONCLUSIONS The XtraSeal could be effective in preventing periprosthetic leakage and lengthening the time between replacements. Studies with a robust methodology are necessary to confirm these results. Managing voice prosthesis is complex and requires a multidisciplinary and systematic approach by experienced professionals to reduce replacements and complications. Incorrect placement of the XtraSeal could cause a foreign body reaction and consequently inflammation, extrusion, or pressure lesions. The Tower of Hercules protocol: (1) Measurement of the tracheoesophageal fistula using the Provox® Measure, (2) Minimization of XtraSeal slack by avoiding the complete visualization of the prosthesis' blue ring, (3) Nasofibroscopic examination of the oesophageal wall confirming both flanges are in correct position; could prevent or minimize complications derived from the use of the XtraSeal.
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Affiliation(s)
- Miguel Mayo-Yáñez
- Otorhinolaryngology - Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), Galicia, Spain
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Universidade de Santiago de Compostela (USC), Galicia, Spain
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
| | - Irma Cabo-Varela
- Otorhinolaryngology - Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), Galicia, Spain
| | - Christian Calvo-Henríquez
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Universidade de Santiago de Compostela (USC), Galicia, Spain
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
- Otorhinolaryngology - Head and Neck Surgery Department, Complexo Hospitalario Universitario Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain
| | - Carlos Chiesa-Estomba
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
- Otorhinolaryngology - Head and Neck Surgery Department, Hospital Universitario Donostia, Donostia, Spain
| | - Jesús Herranz González-Botas
- Otorhinolaryngology - Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), Galicia, Spain
- Otorhinolaryngology - Head and Neck Surgery Department, Hospital Universitario Donostia, Donostia, Spain
- School of Medicine and Odontology, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain
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Landry V, Christopoulos A, Guertin L, Bissada E, Tabet P, Berania I, Royal-Lajeunesse É, Olivier MJ, Ayad T. Patterns of alaryngeal voice adoption and predictive factors of vocal rehabilitation failure following total laryngectomy. Head Neck 2023; 45:2657-2669. [PMID: 37646494 DOI: 10.1002/hed.27491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 07/10/2023] [Accepted: 08/13/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE We aimed to determine patterns of alaryngeal voice acquisition and predictive factors of vocal rehabilitation (VR) failure following total laryngectomy (TL) at a large Canadian tertiary care center. METHODS All consecutive patients having undergone a TL between January 1st, 2011 and December 31st, 2019, at the Centre Hospitalier de l'Université de Montréal were included. RESULTS One hundred and ninety-seven laryngectomized patients were identified. Successful VR was achieved in 86 (59.0%) patients, while 59 (41.0%) failed to use a method of alaryngeal voice as their principal means of communication at 1 year postoperatively. The use of tracheoesophageal puncture (TEP) was associated with higher VR success rates (70.6%) when compared with the artificial larynx (48.6%), and esophageal voice (18.8%). The only independent predictor of VR failure on multivariate analysis at all time points was a low socioeconomic status. CONCLUSION Failure to adopt an alaryngeal voice following TL is highly prevalent, despite comprehensive and free speech language pathologist services being offered at our center. A low resort to TEP at our institution and a poor acceptability and accessibility of alternative VR methods may contribute to this trend. The challenges of VR may be further exacerbated by the barriers linked to a lower socioeconomic status, which in turn may contribute to reduced candidacy for TEP.
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Affiliation(s)
- Vivianne Landry
- Faculty of Medicine, University of Montreal, Montréal, Québec, Canada
| | - Apostolos Christopoulos
- Division of Otolaryngology - Head and Neck Surgery, University of Montreal Hospital Center (CHUM), Montréal, Québec, Canada
| | - Louis Guertin
- Division of Otolaryngology - Head and Neck Surgery, University of Montreal Hospital Center (CHUM), Montréal, Québec, Canada
| | - Eric Bissada
- Division of Otolaryngology - Head and Neck Surgery, University of Montreal Hospital Center (CHUM), Montréal, Québec, Canada
| | - Paul Tabet
- Division of Otolaryngology - Head and Neck Surgery, University of Montreal Hospital Center (CHUM), Montréal, Québec, Canada
| | - Ilyes Berania
- Division of Otolaryngology - Head and Neck Surgery, University of Montreal Hospital Center (CHUM), Montréal, Québec, Canada
| | - Émilie Royal-Lajeunesse
- Division of Otolaryngology - Head and Neck Surgery, University of Montreal Hospital Center (CHUM), Montréal, Québec, Canada
| | - Marie-Jo Olivier
- Division of Otolaryngology - Head and Neck Surgery, University of Montreal Hospital Center (CHUM), Montréal, Québec, Canada
- Division of Otolaryngology - Head and Neck Surgery, Maisonneuve-Rosemont Hospital, Montréal, Québec, Canada
| | - Tareck Ayad
- Division of Otolaryngology - Head and Neck Surgery, University of Montreal Hospital Center (CHUM), Montréal, Québec, Canada
- Division of Otolaryngology - Head and Neck Surgery, Maisonneuve-Rosemont Hospital, Montréal, Québec, Canada
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7
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Barth CMH, Barth CH. [Troubleshooting with difficult replacement of voice prostheses and a novel retrograde procedure]. Laryngorhinootologie 2023; 102:416-422. [PMID: 37267965 DOI: 10.1055/a-2047-3703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The implantation of a voice prosthesis has become a standard procedure during a laryngectomy. A voice prostheses enables patients to develop speech shortly after surgery, which strongly improves rehabilitation and quality of life.The lifetime of a voice prosthesis is limited and highly variable due to different causes. A replacement is usually necessary several times a year and can easily been done in an outpatient setting with surface anesthesia. In some cases, replacing the prosthesis becomes difficult. This article will take a closer look at different reasons that can lead to difficulties in prostheses replacement and discuss possible solutions, thereby focusing especially on a retrograde technique. The aim of this article is to help colleagues that already have experience with voice prostheses and want to expand their therapeutic armamentarium.
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8
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Tang JA, McCarroll L, Schmalbach CE. Voice Restoration and Quality of Life in Larynx Cancer. Otolaryngol Clin North Am 2023; 56:361-370. [PMID: 37030948 DOI: 10.1016/j.otc.2022.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2023]
Abstract
Voice restoration following laryngectomy has a significant influence on quality of life (QOL). Three main techniques exist to provide voice: esophageal speech (ES), artificial larynx (electrolarynx [EL]), and tracheoesophageal puncture (TEP). Although the EL was historically the most used technique, TEP has quickly become the gold standard. ES remains the least frequently used technique in developed countries. Technique selection must be made on an individual basis, considering the patient's cancer history and comorbidities. Ultimately, the choice in voice-restoration technique requires joint decision making with the surgeon, speech pathologist, and patient.
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Affiliation(s)
- Jessica A Tang
- Department of Otolaryngology Head and Neck Surgery, Johns Hopkins Hospital, 601 N. Caroline Street, Baltimore, MD 21287, USA
| | - Liane McCarroll
- Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA
| | - Cecelia E Schmalbach
- Department of Otolaryngology-HNS, Lewis Katz School of Medicine at Temple University, Temple Head & Neck Institute, Fox Chase Cancer Center, 3440 North Broad Street, Kresge West 309, Philadelphia, PA 19140, USA.
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Heirman AN, van der Noort V, van Son R, Petersen JF, van der Molen L, Halmos GB, Dirven R, van den Brekel MWM. Does Prophylactic Replacement of Voice Prosthesis Make Sense? A Study to Predict Prosthesis Lifetime. Otolaryngol Head Neck Surg 2023; 168:429-434. [PMID: 35917180 DOI: 10.1177/01945998221116815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/09/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Voice prosthesis leakage significantly affects the quality of life of patients undergoing laryngectomy, causing insecurity and frequent unplanned hospital visits and costs. In this study, the concept of prophylactic voice prosthesis replacement was explored to prevent leakages. STUDY DESIGN Retrospective cohort study. SETTING Tertiary hospital. METHODS This study included all patients who underwent laryngectomy between 2000 and 2012 in the Netherlands Cancer Institute. Device lifetimes and voice prosthesis replacements of a retrospective cohort were used to calculate the number of needed voice prostheses per patient per year to prevent 70% of the leakages by prophylactic replacement. Various strategies for the timing of prophylactic replacement were considered: adaptive strategies based on the individual patient's history of replacement and fixed strategies based on the results of patients with similar voice prosthesis or treatment characteristics. RESULTS Patients used a median 3.4 voice prostheses per year (range, 0.1-48.1). We found high inter- and intrapatient variability in device lifetime. When prophylactic replacement is applied, this would become a median 9.4 voice prostheses per year, which means replacement every 38 days, implying >6 additional voice prostheses per patient per year. The individual adaptive model showed that preventing 70% of the leakages was impossible for most patients and only a median 25% can be prevented. Monte-Carlo simulations showed that prophylactic replacement is not feasible due to the high coefficient of variation (SD/mean) in device lifetime. CONCLUSION Based on our simulations, prophylactic replacement of voice prostheses is not feasible due to high inter- and intrapatient variation in device lifetime.
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Affiliation(s)
- Anne N Heirman
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Vincent van der Noort
- Department of Biometrics and Statistics, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Rob van Son
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Amsterdam Center of Language and Communication, University of Amsterdam, Amsterdam, the Netherlands
| | - Japke F Petersen
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Lisette van der Molen
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Gyorgy B Halmos
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Richard Dirven
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Michiel W M van den Brekel
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Amsterdam Center of Language and Communication, University of Amsterdam, Amsterdam, the Netherlands
- Department of Maxillofacial Surgery, Amsterdam University Medical Center, Amsterdam, the Netherlands
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Mayo-Yáñez M, Chiesa-Estomba CM, Lechien JR, Maniaci A, van den Brekel M. Commentary on "Voice Rehabilitation by Voice Prostheses After Total Laryngectomy: A Systematic Review and Network Meta-Analysis for 11,918 Patients". JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3452-3455. [PMID: 35868239 DOI: 10.1044/2022_jslhr-22-00137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Miguel Mayo-Yáñez
- Otorhinolaryngology - Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña, Galicia, Spain
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies, Universidade de Santiago de Compostela, Galicia, Spain
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies Study Group, Paris, France
| | - Carlos Miguel Chiesa-Estomba
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies Study Group, Paris, France
- Otorhinolaryngology - Head and Neck Surgery Department, Hospital Universitario Donostia, Gipuzkoa, Spain
| | - Jérôme R Lechien
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies Study Group, Paris, France
- Anatomy and Cell Biology Department, Faculty of Medicine, Research Institute for Health Sciences and Technology, University of Mons, Belgium
- Otorhinolaryngology Department, Elsan Hospital, Paris, France
| | - Antonino Maniaci
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies Study Group, Paris, France
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Italy
| | - Michiel van den Brekel
- Department of Head and Neck Surgery & Oncology, The Netherlands Cancer Institute Amsterdam, Netherlands
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, Netherlands
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Martins de Sousa M, Matos R, Vilarinho H, Santos M, Silveira H. Voice rehabilitation with voice prosthesis: Long term results, complications and risk factors. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022; 73:219-224. [PMID: 35908815 DOI: 10.1016/j.otoeng.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 05/02/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Despite the advances in surgical and non-surgical organ preservation treatments, total laryngectomy (TL) remains the most effective treatment in advanced larynx cancer and as salvage procedure in chemoradiation failure. One of the most devastating sequel after TL is loss of voice. Voice prosthesis (VP) is currently the preferred choice for voice rehabilitation. The purpose of this study is to identify VP complications, its lifespan and factors that influence the longevity of the VP. METHODS We performed a retrospective study at a Tertiary University Hospital. Medical records of patients that underwent total laryngectomy, between January 1st of 2008 and 31st of December of 2017 were analyzed. RESULTS Of the 84 patients that underwent laryngectomy, 60 had VP. The average age at the time of surgery 60.2 years old and there was a male preponderance (57:3). The mean lifespan of the prosthesis was 7.53 months. Leakage through the prosthesis was the most common reason for replacement of the prosthesis, followed by leakage around the prosthesis. Follow up time and manual suture were associated with prosthesis replacement. There was no significant relationship between the staging, tumor location or adjuvant radiotherapy and number of prosthesis replacement or its lifespan. CONCLUSIONS Rehabilitation after TL is of major importance to improve quality of life after surgery. Tracheoesophageal puncture with voice prosthesis is a safe procedure for vocal rehabilitation and was performed in the majority of patients in our study. Follow-up time and type of suture were the main determinants of the lifespan of the prosthesis.
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Affiliation(s)
- Mafalda Martins de Sousa
- Department of Otorhinolaryngology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Department of Surgery and Physiology - Unit of Otorhinolaryngology - Faculty of Medicine, Porto University, Porto, Portugal.
| | - Ricardo Matos
- Department of Otorhinolaryngology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Department of Surgery and Physiology - Unit of Otorhinolaryngology - Faculty of Medicine, Porto University, Porto, Portugal
| | - Helena Vilarinho
- Department of Otorhinolaryngology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - Margarida Santos
- Department of Otorhinolaryngology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - Helena Silveira
- Department of Otorhinolaryngology, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Department of Surgery and Physiology - Unit of Otorhinolaryngology - Faculty of Medicine, Porto University, Porto, Portugal
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Martins de Sousa M, Matos R, Vilarinho H, Santos M, Silveira H. Voice rehabilitation with voice prosthesis: Long term results, complications and risk factors. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022. [DOI: 10.1016/j.otorri.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Mayo-Yáñez M, Chiesa-Estomba C, Lechien JR, Calvo-Henríquez C, Vaira LA, Cabo-Varela I. Long-term outcomes and cost-effectiveness of a magnet-based valve voice prosthesis for endoprosthesis leakage treatment. Eur Arch Otorhinolaryngol 2022; 279:4167-4172. [PMID: 35217904 DOI: 10.1007/s00405-022-07313-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/09/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Tracheoesophageal speech is considered the gold standard for rehabilitation following total laryngectomy. The main reason of voice prosthesis failure is the endoprosthesis leakage. Provox ActiValve® incorporates a magnet-based valve system to achieve active closure of the valve to treat these leakages, with the drawback of being significantly more expensive. The aim of the study was to compare the Provox Vega® and Provox ActiValve® duration and costs in patients with replacements increase due to endoprosthetic leakage. METHODS Prospective case-crossover study in laryngectomized patients with Provox Vega® and endoprosthesis leakage to whom a Provox ActiValve® was placed. Survival and possible factors that affect voice prosthesis were studied using Kaplan-Meier curves and Cox Proportional Hazards Regression. Cost-effectiveness analysis from the perspective of the Spanish Public National Health System with incremental cost-effectiveness calculation was performed. RESULTS A total of 159 prostheses were evaluated. The most frequent reason for replacement was the endoprosthesis leakage (N = 129; 83.77%) in both models. The mean duration-time of Provox Vega® was 44.77 ± 2.82 days (CI 95%, 39.18-50.35; median 36 days), and 317.34 ± 116.8 days (CI 95% 86.66-548; median 286 days) for the Provox ActiValve® (p < 0.000). For every replacement not made thanks to the Provox ActiValve® there was saving of 133.97€ CONCLUSIONS: The Provox ActiValve® is a cost-effective solution in patients with increased prosthesis replacements due to endoprosthetic leakage, reducing the number of changes and cost compared to Provox Vega®.
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Affiliation(s)
- Miguel Mayo-Yáñez
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), As Xubias 84, 15006, A Coruña, Galicia, Spain.
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Universidade de Santiago de Compostela (USC), 15782, Santiago de Compostela, Galicia, Spain.
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France.
| | - Carlos Chiesa-Estomba
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
- Otorhinolaryngology-Head and Neck Surgery Department, Hospital Universitario Donostia, 20014, Donostia, Euskadi, Spain
| | - Jérôme R Lechien
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
- Otolaryngology Department, Elsan Hospital, Paris, France
- Otorhinolaryngology and Head and Neck Surgery Department, Foch Hospital, Paris Saclay University, Paris, France
| | - Christian Calvo-Henríquez
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), Universidade de Santiago de Compostela (USC), 15782, Santiago de Compostela, Galicia, Spain
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario Santiago de Compostela (CHUS), 15706, Santiago de Compostela, Galicia, Spain
| | - Luigi A Vaira
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Irma Cabo-Varela
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), As Xubias 84, 15006, A Coruña, Galicia, Spain
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14
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Tsao CK, Marchi F, Kang CJ, Sampieri C, Lu YA, Huang SF, Chen YT, Giordano G, Peretti G, Parrinello G, Iandelli A, Fang TJ. Comprehensive Evaluation of Vocal Outcomes and Quality of Life after Total Laryngectomy and Voice Restoration with J-Flap and Tracheoesophageal Puncture. Cancers (Basel) 2022; 14:cancers14030544. [PMID: 35158812 PMCID: PMC8833548 DOI: 10.3390/cancers14030544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Laryngopharyngectomy is still the treatment of choice in locally advanced pharyngolaryngeal tumors not eligible for organ preservation protocols. Loss of speech capacity has been reported as one of the factors that most affect the patient-reported quality of life. Thus, the reconstructive goals are restoring the pharynx and possibly the voice in such a scenario. For decades, tracheoesophageal puncture (TEP) has allowed proper voice rehabilitation; however, TEP has a non-neglectable financial expenditure and complication rate. Therefore, we recently reported a novel flap design and surgical technique that shares the same principles of TEP, without the need to change any device over time, named J-flap. This study aimed to analyze both techniques’ subjective and objective vocal outcomes and their impact on overall and voice-related quality of life. Abstract Background: Tracheoesophageal puncture with a voice prosthesis is the gold standard for speech rehabilitation in patients that receive a laryngopharyngectomy. However, a novel surgical technique, using a tubularized anterolateral tight flap, named “J-flap,” has been demonstrated to produce adequate voice restoration. We aimed to compare the outcomes and the quality of life of patients who underwent voice rehabilitation with both techniques. Methods: We enrolled patients that underwent laryngopharyngectomy and voice restoration surgery. The control group received a tracheoesophageal puncture with a voice prosthesis, while the study group received J-flap reconstruction. A total of 20 patients received voice prosthesis rehabilitation, while 18 received J-flap reconstruction. Speech and vocal outcomes and quality of life metrics were collected. Results: The objective phonatory performances and the acoustic voice analysis did not outline a significant difference. Speech pathologists judged the consonant pronunciation in the J-flap group as less accurate (p < 0.001). The voice handicap index revealed a moderate impairment for the J-flap group (p < 0.001). Quality of life scores were higher for the voice prosthesis group. Conclusion: Voice prostheses and J-flaps share similar objective phonatory outcomes. Quality of life was more impaired in the J-flap group. In our view, these two techniques possess complementary characteristics in clinical practice, taking into account health care system regulations and patients’ social background.
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Affiliation(s)
- Chung-Kan Tsao
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-K.T.); (F.M.); (Y.-T.C.)
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan
| | - Filippo Marchi
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-K.T.); (F.M.); (Y.-T.C.)
- Department of Otolaryngology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (C.S.); (G.G.); (G.P.); (G.P.)
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Chung-Jan Kang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-J.K.); (Y.-A.L.); (S.-F.H.)
| | - Claudio Sampieri
- Department of Otolaryngology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (C.S.); (G.G.); (G.P.); (G.P.)
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Yi-An Lu
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-J.K.); (Y.-A.L.); (S.-F.H.)
| | - Shiang-Fu Huang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-J.K.); (Y.-A.L.); (S.-F.H.)
| | - Yu-Ting Chen
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-K.T.); (F.M.); (Y.-T.C.)
| | - Giorgio Giordano
- Department of Otolaryngology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (C.S.); (G.G.); (G.P.); (G.P.)
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Giorgio Peretti
- Department of Otolaryngology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (C.S.); (G.G.); (G.P.); (G.P.)
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Giampiero Parrinello
- Department of Otolaryngology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (C.S.); (G.G.); (G.P.); (G.P.)
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Andrea Iandelli
- Department of Otolaryngology, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (C.S.); (G.G.); (G.P.); (G.P.)
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-J.K.); (Y.-A.L.); (S.-F.H.)
- Correspondence: (A.I.); (T.-J.F.)
| | - Tuan-Jen Fang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei 333, Taiwan; (C.-J.K.); (Y.-A.L.); (S.-F.H.)
- Correspondence: (A.I.); (T.-J.F.)
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15
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Voice Prosthesis Coated with Sustained Release Varnish Containing Clotrimazole Shows Long-Term Protection against Candida albicans: An In Vitro Study. Molecules 2021; 26:molecules26175395. [PMID: 34500827 PMCID: PMC8434179 DOI: 10.3390/molecules26175395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022] Open
Abstract
Fungal biofilm formation on voice prosthesis (VP) is a major health problem that requires repeated replacement of the prosthesis. Candida albicans is one of the pathogens that frequently inhabits the VP. We proposed that coating VPs with sustained-release varnish (SRV) containing clotrimazole (CTZ) might prevent fungal biofilm formation. The long-term antifungal activities of SRV-CTZ- versus SRV-placebo-coated VPs was tested daily by measuring the inhibition zone of C. albicans seeded on agar plates or by measuring the fungal viability of C. albicans in suspension. The extent of biofilm formation on coated VPs was analyzed by confocal microscopy and scanning electron microscopy. We observed that SRV-CTZ-coated VPs formed a significant bacterial inhibition zone around the VPs and prevented the growth of C. albicans in suspension during the entire testing period of 60 days. Fungal biofilms were formed on placebo-coated VPs, while no significant biofilms were observed on SRV-CTZ-coated VPs. HPLC analysis shows that CTZ is continuously released during the whole test period of 60 days at a concentration above the minimal fungistatic concentration. In conclusion, coating VPs with an SRV-CTZ film is a potential effective method for prevention of fungal infections and biofilm formation on VPs.
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16
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Spałek J, Deptuła P, Durnaś B, Król G, Kaliniak S, Bucki R, Okła S. Potential colonization of provox voice prosthesis by Candida spp. with no sign of failure for approximately 10 years exploitation time. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2021. [DOI: 10.1080/23772484.2021.1927737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Jakub Spałek
- Institute of Medical Science, Collegium Medicum, University of Jan Kochanowski, Kielce, Poland
- Department of Otolaryngology, Head and Neck Surgery, Holy-Cross Cancer Center, Kielce, Poland
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok, Poland
| | - Piotr Deptuła
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok, Poland
| | - Bonita Durnaś
- Institute of Medical Science, Collegium Medicum, University of Jan Kochanowski, Kielce, Poland
| | - Grzegorz Król
- Institute of Medical Science, Collegium Medicum, University of Jan Kochanowski, Kielce, Poland
| | - Szczepan Kaliniak
- Department of Otolaryngology, Head and Neck Surgery, Holy-Cross Cancer Center, Kielce, Poland
| | - Robert Bucki
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Bialystok, Poland
| | - Sławomir Okła
- Institute of Medical Science, Collegium Medicum, University of Jan Kochanowski, Kielce, Poland
- Department of Otolaryngology, Head and Neck Surgery, Holy-Cross Cancer Center, Kielce, Poland
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17
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Boyd C, Houghton J, Harrold L, Bond J, Garnett JD, Kraft S. Assessment of Factors Impacting Long-Term Utilization of Tracheoesophageal Speech Among Laryngectomees. Ann Otol Rhinol Laryngol 2020; 130:802-809. [PMID: 33242976 DOI: 10.1177/0003489420976145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE(S) To evaluate complication rate and abandonment rate after tracheoesophageal puncture and to assess factors associated with these outcome measures. METHODS Retrospective review of laryngectomy patients seen at a single academic institution between 1/1/2003 and 12/1/2018. Charts reviewed for demographics, medical comorbidities, tumor characteristics, surgical data, adjuvant treatment history, and complications related to laryngectomy or tracheoesophageal puncture. Complications were divided into minor and major. RESULTS A total of 293 laryngectomees met inclusion criteria. Of these, 69 patients (23.5%) underwent tracheoesophageal puncture. Average follow up was 64.6 months (SD 58.3). Overall laryngectomy complication rate was 43.3%. Overall tracheoesophageal puncture complication rate was 73.9%, with 39.1% of patients having major complications and 34.8% having minor complications only. Total abandonment rate for tracheoesophageal puncture was 34.8%. No associations were seen between tracheoesophageal puncture complication or abandonment rates based on age, gender, race, or insurance status. An increased rate of laryngectomy complications was seen after primary tracheoesophageal puncture (76.5% vs 41.3%, P = .005). CONCLUSION Tracheoesophageal puncture outcomes were similar in patients with varied demographic, medical, and treatment backgrounds. When considering timing, our findings suggest that patients should be counseled on the possibility of increased complication risk after primary tracheoesophageal puncture. In those in whom the surgeon already has concerns about wound healing, it may be prudent to avoid primary tracheoesophageal puncture. The relatively high abandonment rate emphasizes the value of this measure of tracheoesophageal puncture outcome and highlights the need for appropriate patient counseling and prospective studies assessing the decision to abandon.
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Affiliation(s)
- Christopher Boyd
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, KS, USA
| | - James Houghton
- University of Kansas School of Medicine, Kansas City, KS, USA
| | - Logan Harrold
- University of Kansas School of Medicine, Kansas City, KS, USA
| | - Justin Bond
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, KS, USA
| | - James D Garnett
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, KS, USA
| | - Shannon Kraft
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, KS, USA
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18
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Alex J, Salamonson Y, Ramjan LM, Montayre J, Fitzsimons J, Ferguson C. The impact of educational interventions for patients living with indwelling urinary catheters: A scoping review. Contemp Nurse 2020; 56:309-330. [PMID: 33043843 DOI: 10.1080/10376178.2020.1835509] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Aim: To explore the impact of educational interventions for patients living with indwelling urinary catheters. Methods: Systematic scoping review in accordance with PRISMA guidelines, guided by Cochrane methodology, quality appraisal using Centre for Evidence-Based Medicine (CEBM) Joanna Briggs Institute (JBI), GRADE criteria and Quality Improvement Minimum Quality Criteria Set Version 1.0 (QI-MQCS V 1.0) tools. Studies (n = 446) were retrieved from CINAHL, Cochrane Library, Scopus and Medline from 2000 to 2020. Results: A total of 15 primary research studies were included in the narrative thematic synthesis, nine were from the USA, two from Australia, two from the UK, one from Italy and one from Turkey. These 15 studies were published between 2003 and 2019 and accounted for 19918 patients with an age range 15-99 years. Study design varied; there were 11 quantitative and 4 qualitative studies. Studies were of low-moderate quality. A total of four themes were identified; (i) information needs of patients living with long-term catheters; (ii) core learning content and educational approaches; (iii) feasibility and effectiveness of educational interventions to reduce complications and improve quality of life; and (iv) common outcome measures. Conclusion: The dissemination of information and the delivery of urinary catheter education to patients is inadequate. Core components of educational interventions should address fluid intake, bowel management, hygiene and self-monitoring/management, including adverse events. There is a need for future robust trials of educational and self-management interventions to improve the quality of life of patients living with indwelling urinary catheters in the community. Impact: This review addressed the educational needs of patients living with indwelling urinary catheters and the impact of educational interventions. Despite the heterogeneity in educational interventions, all studies included in this review reported the specific approach undertaken was effective in minimising catheter-associated complications and improving the quality of life of patients.
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Affiliation(s)
- Joby Alex
- CNC Continence, Integrated & Community Health, Western Sydney Local Health District, Mt Druitt Community Health Centre, Cnr Buran & Kelly Cl, Mount Druitt, NSW 2770, Australia
| | - Yenna Salamonson
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Lucie M Ramjan
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Jed Montayre
- Western Sydney University, School of Nursing and Midwifery, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Jennifer Fitzsimons
- Nursing and Clinical Governance, Integrated & Community Health, Western Sydney Local Health District, Blacktown Campus, PO Box 792, Seven Hills 2147, Australia
| | - Caleb Ferguson
- Western Sydney Nursing & Midwifery Research Centre, Western Sydney Local Health District, Western Sydney University, COHORT, Ingham Institute for Applied Medical Research, Locked Bag 1797, Penrith NSW 2751, Australia
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19
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Biofilm Growth Causes Damage to Silicone Voice Prostheses in Patients after Surgical Treatment of Locally Advanced Laryngeal Cancer. Pathogens 2020; 9:pathogens9100793. [PMID: 32993180 PMCID: PMC7601089 DOI: 10.3390/pathogens9100793] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 12/16/2022] Open
Abstract
Voice prosthesis implantation with the creation of a tracheoesophageal fistula is the gold standard procedure for voice rehabilitation in patients after a total laryngectomy. All patients implanted with a voice prosthesis (VP) have biofilms of fungi and bacteria grow on their surface. Biofilm colonization is one of the main reasons for VP degradation that can lead to VP dysfunction, which increases the high risk of pneumonia. In a 20-month evaluation period, 129 cases of prostheses after replacement procedures were investigated. Microbiological examination of the biofilms revealed that there were four of the most common fungi species (Candida spp.) and a large variety of bacterial species present. We studied the relationship between the time of proper function of Provox VP, the microorganism composition of the biofilm present on it, and the degradation level of the silicone material. Evaluation of the surface of the removed VP using an atomic force microscope (AFM) has demonstrated that biofilm growth might drastically change the silicone's mechanical properties. Changes in silicone stiffness and thermal properties might contribute to the failure of VP function. Our data can serve in future studies for the development of methods to prevent or inhibit biofilm formation on the VP surface that would translate to an increase in their durability and safety.
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20
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Lu YA, Pei YC, Chuang HF, Lin LY, Hsin LJ, Kang CJ, Huang SF, Chiang HC, Tsao CK, Fang TJ. Speech Performance after Anterolateral Thigh Phonatory Tube Reconstruction for Total Laryngectomy. Laryngoscope 2020; 131:1349-1357. [PMID: 33280117 DOI: 10.1002/lary.29005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/19/2020] [Accepted: 07/20/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Traditionally, after total laryngopharyngectomy (TLP), patients cannot speak without a prosthesis or an artificial larynx. In Taiwan, most patients use a commercialized pneumatic laryngeal device (PLD). Phonatory tube reconstruction with the anterolateral thigh (ALT) flap is a novel, modified version of synchronous digestive and phonatory reconstruction involving a free muscular cutaneous flap. This study reviewed and compared speech performance between patients who underwent novel flap reconstruction and conventional PLD users. METHOD We retrospectively reviewed patients with laryngeal or hypopharyngeal cancer who underwent TLP from August 2017 to September 2019. The voice handicap index (VHI), speech intelligibility, acoustic and aerodynamic analysis results, and speech range profile (SRP) were compared between patients who underwent ALT phonatory tube reconstruction (ALT group) and those using PLDs (PLD group). RESULTS Twenty patients were included; 13 patients were included in the ALT group, and 7 patients were included in the PLD group. Compared to the PLD group, the ALT group had a better fundamental frequency range (P < .001) and semitone range (P < .001) during speech but showed worse jitter, shimmer, and harmonic-to-noise ratios. The two groups showed comparable VHI and speech intelligibility performance. CONCLUSIONS The ALT phonatory tube, a novel flap for reconstruction, can restore digestive and voice functions simultaneously. Compared with PLD use, ALT phonatory tube reconstruction yields an improved speech range and comparable levels of voice handicap and speech intelligibility, suggesting that the technique is a good alternative for patients after TLP. LEVEL OF EVIDENCE 4 Laryngoscope, 131:1349-1357, 2021.
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Affiliation(s)
- Yi-An Lu
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yu-Cheng Pei
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Feng Chuang
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Li-Yun Lin
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Li-Jen Hsin
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chung-Jan Kang
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shiang-Fu Huang
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hui-Chen Chiang
- Graduate School of Management, Ming Chuan University, Taipei, Taiwan
| | - Chung-Kan Tsao
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Plastic and Reconstructive Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tuan-Jen Fang
- Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
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21
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Goldstein DP, Ralph G, de Almeida JR, Jethwa AR, Irish J, Chepeha DB, Brown D, Gullane P, Waldron J, Aziza E, Durkin L. Tracheoesophageal voice prosthesis management in laryngectomy patients during the COVID-19 pandemic. J Otolaryngol Head Neck Surg 2020; 49:59. [PMID: 32778168 PMCID: PMC7416812 DOI: 10.1186/s40463-020-00456-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 07/30/2020] [Indexed: 02/04/2023] Open
Abstract
With the COVID-19 pandemic, there has been significant changes and challenges in the management of oncology patients. One of the major strategies to reduce transmission of the virus between patients and healthcare workers is deferral of follow-up visits. However, deferral may not be possible in total laryngectomy patients. Urgent procedures may be necessary to prevent complications related to ill-fitting tracheoesophageal puncture (TEP) voice prostheses, such as aspiration or loss of voicing. In this paper, we describe the Princess Margaret Cancer Center's approach to managing this unique patient population.
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Affiliation(s)
- David P Goldstein
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada.
| | - Gilbert Ralph
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - John R de Almeida
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Ashok R Jethwa
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Jonathan Irish
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Douglas B Chepeha
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Dale Brown
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Patrick Gullane
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON, Canada
| | - John Waldron
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Elana Aziza
- Speech pathology, University Helth Network, University of Toronto, Toronto, ON, Canada
| | - Lisa Durkin
- Speech pathology, University Helth Network, University of Toronto, Toronto, ON, Canada
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22
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Cocuzza S, Maniaci A, Grillo C, Ferlito S, Spinato G, Coco S, Merlino F, Stilo G, Santoro GP, Iannella G, Vicini C, La Mantia I. Voice-Related Quality of Life in Post-Laryngectomy Rehabilitation: Tracheoesophageal Fistula's Wellness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124605. [PMID: 32604875 PMCID: PMC7344397 DOI: 10.3390/ijerph17124605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/21/2020] [Accepted: 06/24/2020] [Indexed: 02/07/2023]
Abstract
(1) Introduction: Laryngeal cancer is one of the most common types of cancer affecting the upper aerodigestive tract. Despite ensuring good oncological outcome in many locoregionally advanced cases, total laryngectomy is associated with relevant physical and psychological sequelae. Treatment through tracheo-esophageal speech, if promising, can lead to very variable outcomes. Not all laryngectomee patients with vocal prosthesis benefit from the same level of rehabilitation mainly due to the development of prosthetic or fistula related problems. The relating sequelae in some cases are even more decisive in the patient quality of life, having a higher impact than communicational or verbal skills. (2) Material and Methods: A retrospective study was conducted on 63 patients initially enrolled with a history of total laryngectomy and voice rehabilitation, treated at the University Hospital of Catania from 1 January 2010 to 31 December 2018. Quality of life (QoL) evaluation through validated self-administrated questionnaires was performed. (3) Results: The Voice-Related Quality of Life questionnaire revealed significantly better outcomes in both socio-emotional and functional domains of the tracheoesophageal patient group compared to the esophageal group (p = 0.01; p = 0.01, respectively), whereas in the Voice Handicap Index assessment, statistically significant scores were not achieved (p = 0.33). (4) Discussion: The significant differences reported through the V-RQOL and Voice Handicap Index scales in the presence of fistula related problems and device lifetime reduction when compared to the oesophageal speech group have demonstrated, as supported by the literature, a crucial role in the rehabilitative prognosis. (5) Conclusions: The criteria of low resistance to airflow, optimal tracheoesophageal retention, prolonged device life, simple patient maintenance, and comfortable outpatient surgery are the reference standard for obtaining good QoL results, especially over time. Furthermore, the correct phenotyping of the patient based on the main outcomes achieved at clinical follow-up guarantees the primary objective of the identification of a better quality of life.
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Affiliation(s)
- Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
| | - Antonino Maniaci
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
- Correspondence:
| | - Calogero Grillo
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
| | - Salvatore Ferlito
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
| | - Giacomo Spinato
- Section of Otorhinolaryngology, University of Padova, 31100 Treviso, Italy;
| | - Salvatore Coco
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
| | - Federico Merlino
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
| | - Giovanna Stilo
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
| | - Giovanni Paolo Santoro
- Head and Neck and Robotic Surgery, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy;
| | - Giannicola Iannella
- Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni, L. Pierantoni Hospital, 47121 Forlì, Italy; (G.I.); (C.V.)
- Department of Organi di Senso, University “Sapienza”, 00185 Rome, Italy
| | - Claudio Vicini
- Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni, L. Pierantoni Hospital, 47121 Forlì, Italy; (G.I.); (C.V.)
- Department of Otolaryngology, Head and Neck Surgery, University of Ferrara, 44121 Ferrara, Italy
| | - Ignazio La Mantia
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, 95100 Catania, Italy; (S.C.); (C.G.); (S.F.); (S.C.); (F.M.); (G.S.); (I.L.M.)
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Pentland DR, Stevens S, Williams L, Baker M, McCall C, Makarovaite V, Balfour A, Mühlschlegel FA, Gourlay CW. Precision Antifungal Treatment Significantly Extends Voice Prosthesis Lifespan in Patients Following Total Laryngectomy. Front Microbiol 2020; 11:975. [PMID: 32508787 PMCID: PMC7251058 DOI: 10.3389/fmicb.2020.00975] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/22/2020] [Indexed: 11/13/2022] Open
Abstract
Indwelling silicone valves called voice prostheses (VPs) are the gold standard for speech rehabilitation in patients with laryngeal cancer following total laryngectomy. Reported VP lifespans amongst these patients are highly variable but when devices fail patients experience loss of voice and an increase risk of chest infection. Early failure of VP is a current clinical concern that is associated with regular hospital visits, reduced quality of life and associated medical cost. Poly-microbial biofilms comprised of both bacterial and fungal microorganisms readily colonize VPs and are linked to loss of device performance and its early failure in addition to providing a reservoir for potential infection. Our detailed analysis of poly-microbial biofilm composition on 159 early failing VPs from 48 total laryngectomy patients confirmed Candida albicans as the predominant fungal species and Staphylococcus aureus as the most common bacterial colonizer within our patient cohort. Using a combination of microbiological analysis, patient data and a high-throughput antifungal test assay mimicking in vivo conditions we established an evidence based precision antifungal treatment approach to VP management. Our approach has allowed us to implement a personalized VP management pathway, which increases device in situ lifespan by an average of 270%. Our study represents a significant step forward in both our understanding of the cause of VP failure and a new effective treatment pathway that offers tangible benefit to patients.
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Affiliation(s)
- Daniel R Pentland
- Kent Fungal Group, School of Biosciences, University of Kent, Kent, United Kingdom
| | - Sarah Stevens
- East Kent Hospitals, University NHS Foundation Trust, Kent, United Kingdom
| | - Leila Williams
- East Kent Hospitals, University NHS Foundation Trust, Kent, United Kingdom
| | - Mark Baker
- East Kent Hospitals, University NHS Foundation Trust, Kent, United Kingdom
| | - Carolyn McCall
- East Kent Hospitals, University NHS Foundation Trust, Kent, United Kingdom
| | | | - Alistair Balfour
- East Kent Hospitals, University NHS Foundation Trust, Kent, United Kingdom
| | | | - Campbell W Gourlay
- Kent Fungal Group, School of Biosciences, University of Kent, Kent, United Kingdom
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24
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Repova B, Zabrodsky M, Plzak J, Kalfert D, Matousek J, Betka J. Text-to-speech synthesis as an alternative communication means after total laryngectomy. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2020; 165:192-197. [PMID: 32367081 DOI: 10.5507/bp.2020.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/06/2020] [Indexed: 11/23/2022] Open
Abstract
AIMS Total laryngectomy still plays an essential part in the treatment of laryngeal cancer and loss of voice is the most feared consequence of the surgery. Commonly used rehabilitation methods include esophageal voice, electrolarynx, and implantation of voice prosthesis. In this paper we focus on a new perspective of vocal rehabilitation utilizing alternative and augmentative communication (AAC) methods. METHODS AND PATIENTS 61 consecutive patients treated by means of total laryngectomy with or w/o voice prosthesis implantation were included in the study. All were offered voice banking and personalized speech synthesis (PSS). They had to voluntarily express their willingness to participate and to prove the ability to use modern electronic communication devices. RESULTS Of 30 patients fulfilling the study criteria, only 18 completed voice recording sufficient for voice reconstruction and synthesis. Eventually, only 7 patients started to use this AAC technology during the early postoperative period. The frequency and total usage time of the device gradually decreased. Currently, only 6 patients are active users of the technology. CONCLUSION The influence of communication with the surrounding world on the quality of life of patients after total laryngectomy is unquestionable. The possibility of using the spoken word with the patient's personalized voice is an indisputable advantage. Such a form of voice rehabilitation should be offered to all patients who are deemed eligible.
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Affiliation(s)
- Barbora Repova
- Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol
| | - Michal Zabrodsky
- Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol
| | - Jan Plzak
- Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol
| | - David Kalfert
- Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol
| | - Jindrich Matousek
- Department of Cybernetics, University of West Bohemia in Pilsen, Pilsen, Czech Republic
| | - Jan Betka
- Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University in Prague and University Hospital Motol
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25
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Taberna M, Gil Moncayo F, Jané-Salas E, Antonio M, Arribas L, Vilajosana E, Peralvez Torres E, Mesía R. The Multidisciplinary Team (MDT) Approach and Quality of Care. Front Oncol 2020; 10:85. [PMID: 32266126 PMCID: PMC7100151 DOI: 10.3389/fonc.2020.00085] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 01/16/2020] [Indexed: 12/17/2022] Open
Abstract
The core function of a multidisciplinary team (MDT) is to bring together a group of healthcare professionals from different fields in order to determine patients' treatment plan. Most of head and neck cancer (HNC) units are currently led by MDTs that at least include ENT and maxillofacial surgeons, radiation and medical oncologists. HNC often compromise relevant structures of the upper aerodigestive tract involving functions such as speech, swallowing and breathing, among others. The impairment of these functions can significantly impact patients' quality of life and psychosocial status, and highlights the crucial role of specialized nurses, dietitians, psycho-oncologists, social workers, and onco-geriatricians, among others. Hence, these professionals should be integrated in HNC MDTs. In addition, involving translational research teams should also be considered, as it will help reducing the existing gap between basic research and the daily clinical practice. The aim of this comprehensive review is to assess the role of the different supportive disciplines integrated in an MDT and how they help providing a better care to HNC patients during diagnosis, treatment and follow up.
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Affiliation(s)
- Miren Taberna
- Medical Oncology Department, Catalan Institute of Oncology (ICO), ONCOBELL, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Francisco Gil Moncayo
- Psicooncology Department, Catalan Institute of Oncology (ICO), IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Enric Jané-Salas
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Barcelona, Spain.,Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Maite Antonio
- Oncogeriatrics Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lorena Arribas
- Clinical Nutrition Unit, Catalan Institute of Oncology (ICO), IDIBELL, L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Esther Vilajosana
- Head and Neck Nurse, Head and Neck Functional Unit, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Elisabet Peralvez Torres
- Expert SLP in Oncologic Patients, Head of SLP's Department, Atos Medical Spain, Barcelona, Spain
| | - Ricard Mesía
- Medical Oncology Department, Catalan Institute of Oncology (ICO), B-ARGO, Barcelona, Spain
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26
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Brook I, Goodman JF. Tracheoesophageal Voice Prosthesis Use and Maintenance in Laryngectomees. Int Arch Otorhinolaryngol 2020; 24:e535-e538. [PMID: 33101522 PMCID: PMC7575387 DOI: 10.1055/s-0039-3402497] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 11/21/2019] [Indexed: 10/31/2022] Open
Abstract
AbstractTracheoesophageal speech is the most common voicing method used by laryngectomees. This method requires the installation of tracheoesophageal prosthesis (TEP), which requires continuous maintenance to achieve optimal speaking abilities and prevent fluid leakage from the esophagus to the trachea. The present manuscript describes the available types of TEPs, the procedures used to maintain them, the causes for their failure due to fluid leakage, and the methods used for their prevention. Knowledge and understanding of these issues can assist the otolaryngologist in caring for laryngectomees who use tracheoesophageal speech.
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Affiliation(s)
- Itzhak Brook
- Department of Pediatrics/Medicine, Georgetown University, Washington, District of Columbia, United States
| | - Joseph F Goodman
- Department of Otolaryngology, George Washington University School of Medicine, Washington, District of Columbia, United States
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27
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Mutlu A, Koroglu E, Erdogan S. A Single Voice Prosthesis Utilized For 17 Years. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2019; 31:387-389. [PMID: 31857984 PMCID: PMC6914323 DOI: 10.22038/ijorl.2019.30795.2007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Introduction Surgical procedures, especially total laryngectomy, have a profound adverse effect on the patient's physical, functional, as well as emotional health, and strongly decrease quality of life. Tracheoesophageal puncture is one of the most significant method that is widely performed successfully by physicians. Current valve technology enables long expiring duration; however, general duration for all types of valve appears to be approximately 3 to 6 months. Case Report A 72-year-old patient with total laryngectomy and tracheoesophageal voice prosthesis (VP) presented our voice clinic with difficulty in swallowing and leakage around the valve of VP. In this report, we aim to present the patient who has used a single voice prosthesis for 17 years without a complication. Conclusion In our case, the nutritional habits of our patient may have allowed him to use VP for 17 years without complications. We strongly advise following the suggested renewal time of voice prosthesis.
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Affiliation(s)
- Ahmet Mutlu
- Department of Otorhinolaryngology, Istanbul Medeniyet University Goztepe Research and Training Hospital, Istanbul, Turkey
| | - Erdem Koroglu
- Department of Otorhinolaryngology, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Selvet Erdogan
- Department of Otorhinolaryngology, Kocaeli University Medical Faculty, Kocaeli, Turkey
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28
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Galli A, Giordano L, Biafora M, Tulli M, Di Santo D, Bussi M. Voice prosthesis rehabilitation after total laryngectomy: are satisfaction and quality of life maintained over time? ACTA ACUST UNITED AC 2019; 39:162-168. [PMID: 31131835 PMCID: PMC6536029 DOI: 10.14639/0392-100x-2227] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/16/2018] [Indexed: 11/24/2022]
Abstract
Total laryngectomy is the standard of care for advanced laryngeal/hypopharyngeal cancer. Effective voice rehabilitation is mandatory and tracheo-oesophageal speech (TES) has progressively gained approval. In 2011, we evaluated quality of life (QoL) and satisfaction after TES rehabilitation, demonstrating its efficacy in highly motivated subjects. The aim of the present study was to investigate whether those results are maintained over time within the same selected cohort. 15 of 24 patients were left with a minimum 12 year-follow up after voice prosthesis (VP) implantation. Short Form 36-Item Health Survey (SF-36) for QoL assessment and a study-specific structured questionnaire for evaluation of TES-related satisfaction were employed. The 9/24 patients who dropped out from the follow-up were excluded from the original count and the former results were recalculated. A control group of subjects with minor ENT diseases was used for SF-36 analysis. Many SF-36 items (RP, BP, SF, RE) significantly improved over time, approaching the results of the control group. VP duration also increased (6.3 ± 3.1 against 3.0 ± 1.8 months). TES-related satisfaction items did not change in a statistically significant way. Three patients (20.0%) would not have chosen the same kind of voice restoration: these subjects are those more distant from our institution (230 km and 462 km, respectively, against a mean distance of 15.4 ± 13.8 km for other patients). With the present work, we highlight how the striking results of TES can not only be maintained over time (i.e. TES-related satisfaction), but also substantially improve (i.e. QoL). An integrated, widespread network of centres for VP management is needed to optimise patient follow-up and allow studies on larger series.
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Affiliation(s)
- A Galli
- Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy
| | - L Giordano
- Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy
| | - M Biafora
- Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy
| | - M Tulli
- Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy
| | - D Di Santo
- Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy
| | - M Bussi
- Department of Otorhinolaryngology, San Raffaele Scientific Institute, Milan, Italy
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29
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Petersen JF, Lansaat L, Timmermans AJ, van der Noort V, Hilgers FJM, van den Brekel MWM. Postlaryngectomy prosthetic voice rehabilitation outcomes in a consecutive cohort of 232 patients over a 13-year period. Head Neck 2019; 41:623-631. [PMID: 30614644 PMCID: PMC6590326 DOI: 10.1002/hed.25364] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/22/2018] [Accepted: 05/17/2018] [Indexed: 11/09/2022] Open
Abstract
Background With the increasing necessity for total laryngectomy (TL) after prior (chemo)radiotherapy, prosthetic vocal rehabilitation outcomes might have changed. Methods Retrospective cohort study including all patients laryngectomized between 2000 and 2012 with a voice prosthesis (VP) in the Netherlands Cancer Institute. Results Median device lifetimes of the standard Provox2 and Vega VPs are 63 and 66 days, respectively, and for the problem‐solving ActiValve Light and Strong VPs 143 and 186 days, respectively. In multivariable analysis, salvage TL and TL for a dysfunctional larynx (compared to primary TL) were associated with a shorter device lifetime. Almost half of the patients (48%) experienced tracheoesophageal puncture tract‐related problems, and this concerned 12% of all VP replacements. Conclusions Compared to historical cohorts, device lifetimes of regular Provox2 and Vega voice prostheses have decreased. Complications are not occurring more frequently but affect more patients. Nevertheless, the clinical reliability and validity of prosthetic voice rehabilitation is still sound.
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Affiliation(s)
- Japke F Petersen
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Liset Lansaat
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Adriana J Timmermans
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Frans J M Hilgers
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Institute of Phonetic Sciences-Amsterdam Center of Language and Communication, University of Amsterdam, Amsterdam, The Netherlands
| | - Michiel W M van den Brekel
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Institute of Phonetic Sciences-Amsterdam Center of Language and Communication, University of Amsterdam, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands
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30
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Petersen JF, Lansaat L, Hilgers F, van den Brekel M. Solving periprosthetic leakage with a novel prosthetic device. Laryngoscope 2018; 129:2299-2302. [PMID: 30467857 PMCID: PMC6859417 DOI: 10.1002/lary.27645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Japke F Petersen
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Liset Lansaat
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Frans Hilgers
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Institute of Phonetic Sciences-Amsterdam Center of Language and Communication, University of Amsterdam, Amsterdam, The Netherlands
| | - Michiel van den Brekel
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Institute of Phonetic Sciences-Amsterdam Center of Language and Communication, University of Amsterdam, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands
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31
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Zenga J, Goldsmith T, Bunting G, Deschler DG. State of the art: Rehabilitation of speech and swallowing after total laryngectomy. Oral Oncol 2018; 86:38-47. [DOI: 10.1016/j.oraloncology.2018.08.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/22/2018] [Accepted: 08/31/2018] [Indexed: 10/28/2022]
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32
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Mayo-Yáñez M, Cabo-Varela I, Dovalo-Carballo L, Calvo-Henríquez C, Martínez-Morán A, Herranz González-Botas J. Provox 2 ® and Provox Vega ® device life-time: a case-crossover study with multivariate analysis of possible influential factors and duration. Eur Arch Otorhinolaryngol 2018; 275:1827-1830. [PMID: 29799083 DOI: 10.1007/s00405-018-5008-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 05/19/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Tracheoesophageal speech is considered the gold standard for rehabilitation following total laryngectomy. Current literature is limited and contradictory about the possible causes of device failure. The aim of the study is to compare the device life-time between the Provox 2 and Provox Vega and to examine possible related factors that influence their duration. METHODS Retrospective case-crossover study in 34 laryngectomized patients who had undergone tracheoesophageal voice rehabilitation using indwelling Provox 2 and Provox Vega voice prostheses between 2010 and 2016 in a tertiary care centre. RESULTS A total of 440 prostheses were evaluated. The most frequent reason for replacement was due to an endoprosthesis leakage (n = 221, 64.2%) in both models. Radiotherapy increases the risk of prosthesis replacement (IRR = 1.88, p = 0.007) as well as bilateral neck dissection (IRR = 1.56, p = 0.017) in Provox 2. Age and unilateral neck dissection do not seem to influence the duration of the prosthesis. Mean life-time of Provox 2 was 106.64 days and 124.19 days for Provox Vega (p = 0.261). Complementary treatment with radiotherapy demonstrated a lower device survival (p < 0.001). DISCUSSION Results confirmed the non-significant differences on device life between Provox Vega and Provox 2, as well as the relevant role of radiotherapy treatment in the increase of replacements and diminution of the device duration.
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Affiliation(s)
- Miguel Mayo-Yáñez
- Otorhinolaryngology and Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), Xubias de Arriba, 84, 15006, A Coruña, Spain.
| | - Irma Cabo-Varela
- Otorhinolaryngology and Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), Xubias de Arriba, 84, 15006, A Coruña, Spain
| | - Loredana Dovalo-Carballo
- Speech Therapy, School of Educational Sciences, Universidade da Coruña (UDC), 15010, A Coruña, Spain
| | - Christian Calvo-Henríquez
- Otorhinolaryngology Department, Complexo Hospitalario Universitario Santiago de Compostela (CHUS), 15706, Santiago de Compostela, Spain
| | - Alejandro Martínez-Morán
- Otorhinolaryngology and Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), Xubias de Arriba, 84, 15006, A Coruña, Spain
| | - Jesús Herranz González-Botas
- Otorhinolaryngology and Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), Xubias de Arriba, 84, 15006, A Coruña, Spain.,School of Medicine, Universidade de Santiago de Compostela (USC), 15782, Santiago de Compostela, Spain
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Leonhard M, Zatorska B, Moser D, Tan Y, Schneider-Stickler B. Evaluation of combined growth media for in vitro cultivation of oropharyngeal biofilms on prosthetic silicone. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:45. [PMID: 29633010 PMCID: PMC5891558 DOI: 10.1007/s10856-018-6051-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/19/2018] [Indexed: 06/08/2023]
Abstract
In the upper aerodigestive tract, biofilm deposits by oropharyngeal microbes can cause failure of medical polymer devices like voice prostheses. Previous studies on testing of inhibitive strategies still lack of comparability due to varying study protocols concerning growth media, microbial species and growth conditions. Goal of the study was therefore to test cultivation of a mixed biofilm of isolated oropharyngeal microbes under in vitro growth conditions using mixtures of common growth media. Mixtures of yeast peptone dextrose medium (YPD), fetal bovine serum (FBS), RPMI 1640, Yeast nitrogen base medium (YNB) and brain heart infusion (BHI) were tested to grow mixed biofilm deposits of Candida albicans, Candida tropicalis, Staphylococcus aureus, Streptococcus epidermidis, Rothia dentocariosa and Lactobacillus gasseri on medical grade silicone. Periodic assessment of living biofilm was performed over 22 days by a digital microscope and the cultivated biofilm structures were analyzed by scanning electron microscopy after completion of the study. Mixtures of BHI, YPD and FBS improved microscopic growth of multispecies biofilm deposits over time, while addition of RPMI and YNB resulted in reduction of visible biofilm deposit sizes. A mixtures of FBS 30% + YPD 70% and BHI 30% + YPD 70% showed enhanced support of permanent surface growth on silicone. Growth kinetics of in vitro multispecies biofilms can be manipulated by using mixtures of common growth media. Using mixtures of growth media can improve growth of longterm multispecies oropharyngeal biofilm models used for in vitro testing of antibiofilm materials or coatings for voice prostheses.
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Affiliation(s)
- M Leonhard
- Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - B Zatorska
- Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - D Moser
- Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Y Tan
- Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - B Schneider-Stickler
- Department of Otorhinolaryngology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
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Krishnamurthy A, Khwajamohiuddin S. Analysis of Factors Affecting the Longevity of Voice Prosthesis Following Total Laryngectomy with a Review of Literature. Indian J Surg Oncol 2018; 9:39-45. [PMID: 29563733 PMCID: PMC5856693 DOI: 10.1007/s13193-017-0700-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 08/28/2017] [Indexed: 10/18/2022] Open
Abstract
Tracheoesophageal voice puncture (TEP) coupled with the use of voice prosthesis has been considered as the gold standard for speech rehabilitation in patients of advanced laryngeal/hypopharyngeal carcinomas, who have undergone a total laryngectomy with or without partial pharyngectomy. Although prosthetic voice rehabilitation is commonly practiced worldwide including India, there is a paucity of published Indian data, more so in the current era of organ conservation. This study included 60 laryngectomized patients with a prosthetic voice rehabilitation at a tertiary cancer center in South India between January 1, 2010 and December 31, 2013. Among the 60 patients, the primary site of cancer was the larynx in 43 patients and hypopharynx in the remaining 17. All patients had undergone a primary TEP insertion, 55 in the upfront setting and five in the salvage (post-radiation/chemo-radiation) setting. The ability to retain a successful trachea-esophageal speech on follow-up (median 15.5 months) in our series was around 82%. The mean device life of voice prosthesis in our patient cohort was 16 months. There was surprisingly no significant difference in the prosthesis device life on correlation with age, co-morbidities, habitat, literacy status, pre-operative tracheostomy, setting of surgery, and the extent of surgery. Our series has successfully demonstrated the safety and feasibility of using primary TEP coupled with the use of voice prosthesis for voice rehabilitation in properly selected and motivated patients of advanced laryngeal and hypopharyngeal carcinomas across all clinical settings. A mean device life of 16 months makes prosthetic voice rehabilitation, an attractive as well as a financially viable option for patients in a resource constrained setting.
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Affiliation(s)
- Arvind Krishnamurthy
- Surgical Oncology, Cancer Institute (WIA), 38, Sardar Patel Rd, Adyar, Chennai, 600036 India
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Leonhard M, Zatorska B, Tan Y, Moser D, Schneider-Stickler B. In vitro biofilm growth on modern voice prostheses. Head Neck 2017; 40:763-769. [DOI: 10.1002/hed.25053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 09/07/2017] [Accepted: 11/16/2017] [Indexed: 11/05/2022] Open
Affiliation(s)
- Matthias Leonhard
- Department of Otorhinolaryngology; Medical University of Vienna; Vienna Austria
| | - Beata Zatorska
- Department of Otorhinolaryngology; Medical University of Vienna; Vienna Austria
| | - Yulong Tan
- Department of Otorhinolaryngology; Medical University of Vienna; Vienna Austria
| | - Doris Moser
- Department of Cranio-Maxillofacial and Oral Surgery; Medical University of Vienna; Vienna Austria
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