Clinical Outcomes for Patients with Voice Prosthesis

Abstract

Tracheoesophageal shunt utterance using a voice prosthesis as a substitute voice after laryngectomy is an excellent method and is widely used. However, in addition to temporary removal due to complications, the use of voice prostheses is occasionally discontinued for various reasons that lead to their permanent removal. We evaluated the voice acquisition rate, complications, and outcomes of 23 patients who underwent voice reconstruction using a voice prosthesis after total laryngectomy in our department from January 2007 to December 2018. The voice acquisition rate was 87%. Seven complications occurred in six cases, the most common of which was granulation, followed by leakage and infection in one case each, although all were eventually rescued. However, there were five cases where permanent voice prosthesis removal was necessary for reasons other than complications. Three of these patients had good voice acquisition but were unable to use the voice prosthesis due to the effects of other diseases. In the other two cases, a voice could not be obtained, and the patients expressed their desire to have the prosthesis removed. In the future, aging of voice prosthesis users and long-term use are expected, which will make it necessary not only to accurately determine the adaptation in consideration of the patient’s intention, activity and living environment but also to consider how to proceed when voice prosthesis use becomes difficult due to other diseases.