DETERIORATION OF THE PROVOX(TM) SILICONE TRACHEOESOPHAGEAL VOICE PROSTHESIS - MICROBIAL ASPECTS AND STRUCTURAL-CHANGES

Device life of tracheoesophageal voice prostheses is limited due to de terioration of the polymers. A group of 55 postlaryngectomy patients f itted with a Provox(TM) voice prosthesis have been studied prospective ly during 6 months. Thirty-seven prostheses were replaced due to a dys functional valve mechanism. Although colonization with Candida species was highly associated with destruction of the silicone material, othe r upper respiratory tract commensals, e.g. Staphylococcus aureus, were also demonstrated. Electron microscopy of the contaminated devices sh owed colonization and disruption of the silicone material by penetrati ng yeast hyphae. During the study a remarkable increase of intratrache al phonatory pressures was assessed with progressive colonization of t he prostheses.