gms | German Medical Science

82nd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

01.06. - 05.06.2011, Freiburg

A new modification of vocal chord prothesis

Meeting Abstract

  • corresponding author presenting/speaker Basel Al Kadah - ENT-Uni, Homburg, Germany
  • Carl-Albert Bader - ENT-Uni, Homburg, Germany
  • Klaus Bumm - ENT-Uni, Homburg, Germany
  • Mathias Schneider - Epithesis Manufacturing, Zweibrücken, Germany
  • Bernhard Schick - ENT-Uni, Homburg, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 82nd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Freiburg, 01.-05.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11hno01

DOI: 10.3205/11hno01, URN: urn:nbn:de:0183-11hno018

Published: August 3, 2011

© 2011 Al Kadah et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Background: The undesired dilatation of the tracheooesophageal shunt after surgical implantation with a vocal chord prothesis is a typical complication of this procedure. Temporary removal of the prothesis and reinsertion after a short period of time is a first-line therapeutical option aiming towards an atrophy of the shunt. Failure of this measure generally leads the indication to revision surgery. We present another option of treating leakage problems with vocal chord prothesises without surgical intervention in specified cases.

Material and Methods: 9 Patients (1 female, 8 male) ageing between 51 to 71 years were provided with a custom built vocal chord prothesis due to shunt leakage over a period of time between 11/2008 and 11/ 2010 in the ENT department of the University Hospital of Homburg/Saar. A “Provox 2”® vocal chord prothesis was modified with two discs made of silicone each on the tracheal and oesophageal side and additionally reinforcing the diameter of the prothesis by a silicone tube. The modified prothesis has to be inserted in a retrograde way, analogical to the approach used with the “Provox 1”®-prothesis. The period of observation ranged between 6 and 24 months.

Results: As a measure of control swallowing of methylene blue was used. In all cases leakage suspended. Durability of the modified prothesis ranged between 2 and 6 months. Impairment of the quality of the voice could not be testified by the patients and physician subjectively.

Conclusion: Modifications of „Provox 2“® -prothesis should be regarded in individual cases and constitutes a reasonable alternative to revision surgery. A surgical approach in itself is more intricate and costly, more taxing for the patient and susceptible to failure. We regard the necessity of general anaesthesia for the insertion of the modified prothesis as a disadvantage.

Key words: individual vocal chord prothesis, shunt leakage, fistula leakage, laryngectomy