VOCAL REHABILITATION AFTER TOTAL LARYNGECTOMY USING THE PROVOX VOICE PROSTHESIS

Vocal rehabilitation in laryngectomized patients can be attained by su rgical (tracheoesophageal speech) or conservative methods (oesophageal speech or artificial larynx). We prospectively studied voice restorat ion in 37 patients who underwent total laryngectomy in the period from February 1991 to February 1993. The patients were given the opportuni ty to assess both non-shunt oesophageal speech and shunt oesophageal s peech using the Provox voice prosthesis. The Provox low resistance, se lf-retaining voice prosthesis is a biflanged device made of silicon ru bber. A primary tracheoesophageal puncture was made in 28 patients, wh ile a secondary puncture was performed in another nine patients. The r esults were assessed according to criteria established at the 'Third I nternational Congress on Voice Prosthesis' in Groningen (1988). Functi onal tracheoesophageal speech after primary puncture was achieved in 9 5% of patients 12 months after puncture, while oesophageal voice was a cquired by 55%. Only minor surgical and prosthesis-related complicatio ns were encountered during this follow-up period in 29% of the patient s. The device lifetime varied from 3 months to at least 2 years (mean 5.4 months).