CHEMOPROPHYLAXIS OF FUNGAL DETERIORATION OF THE PROVOX SILICONE TRACHEOESOPHAGEAL PROSTHESIS IN POSTLARYNGECTOMY PATIENTS

A double-blind randomized trial was conducted among 36 laryngectomees to assess the influence of a buccal bioadhesive slow-release tablet co ntaining miconazole nitrate on the lifetime of the Provox voice prosth esis. All patients colonized with Candida spp and treated with miconaz ole showed a significant decrease of colonization at the end of the st udy. Intratracheal phonatory pressures were remarkably higher after 2 months of follow-up in the placebo group. No local or systemic adverse reactions to miconazole were observed during this study. Patient comp liance was acceptable according to regular miconazole determination in saliva samples. The device lifetime was significantly higher in patie nts treated with miconazole even after 1 year of follow-up. The use of a buccal bioadhesive slow-release tablet containing an antimycotic ag ent proves to be an adequate method of preventing fungal colonization and deterioration of silicone voice prostheses.