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76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

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

04.05. - 08.05.2005, Erfurt

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Prosthetic voice rehabilitation after laryngectomy - complications after initial radiation

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  • corresponding author Frank Rosanowski - Dpt. Phoniatrics and Pedaudiology, Erlangen University Hospital, Erlangen
  • Maria Schuster - Dpt. Phoniatrics and Pedaudiology, Erlangen University Hospital, Erlangen
  • Ulrich Eysholdt - Dpt. Phoniatrics and Pedaudiology, Erlangen University Hospital, Erlangen
  • Peter Kummer - Dpt. Phoniatrics and Pedaudiology, Erlangen University Hospital, Erlangen

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno120

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2005/05hno085.shtml

Published: September 22, 2005

© 2005 Rosanowski 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

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Background: Indwelling voice prosthesis proved to be state-of-the-art of postlaryngectomy voice rehabilitation. The aim of this study was to identify the impact of radiation prior to tracheoesophageal puncture on success rate and complications. Patients and methods: We undertook a retrospective study of 145 patients who had undergone prosthetic voice restoration between 1990 and 2002 (Provox® and Provox2®). Risks of functional failure and complications of 17 patients with previous radiation were compared to those of 128 patients without previous radiation.

Results: Previous radiation increased not only the risk of functional failure by 2.9 (p=0.023), but also the risk of shunt-related complications such as aspiration around the prosthesis (1.51; p=0.046), widening of the shunt (2.32; p=0.014), esophageal (2.51; p=0.013) or tracheal (3.29; p=0.0023) dislocation of the prosthesis and spontaneous (2.51; p=0.047) or surgical closure (3.76; p=0.037) of the shunt.

Conclusion: Primary tracheoesophageal puncture during laryngectomy is recommended in cases without previous radiation, especially when postlaryngectomy radiation is likely. In patients with previous radiation, generally good success rates decrease, however, without absolute contraindication of tracheoesophageal puncture. These results may affect salvage surgery concepts.