THE GRONINGEN, NIJDAM AND PROVOX VOICE PROSTHESES - A PROSPECTIVE CLINICAL COMPARISON BASED ON 845 REPLACEMENTS

The Groningen, Nijdam and Provox voice prostheses (VP) are all low-pre ssure, indwelling voice prostheses. Although there are differences con cerning the valve mechanism, they have a similar design and are theref ore interchangeable. In a prospective study, 845 consecutive replaceme nts were evaluated in 158 patients. Average device lifetime differed s ignificantly from 13 weeks for the Provox VP and 15.8 weeks for the Gr oningen VP, to 19 weeks for the Nijdam device. Leakage through or arou nd a voice prosthesis was the main replacement indication. Leakage occ urred significantly more often with the Provox VP (80.2%) than with th e Groningen VP (58.8%) or the Nijdam VP (55%). Increased airflow resis tance as a replacement indication occurred significantly more often wi th the Groningen VP (45.4%) and the Nijdam VP (45.9%) than with the Pr ovox VP (22.7%). Complications during the replacement procedure were r are and usually mild. Replacement was usually an easy outpatient proce dure; general anaesthesia was only necessary in 3.0% of 845 replacemen ts, without any significant difference between the three devices. Gran ulation tissue and hypertrophic scar tissue formation were the most fr equent local complications. They occurred in less than 10% of our pati ents but were significantly more common in patients with a Nijdam VP.