[Management of complications after prosthetic voice rehabilitation]

The growing popularity of prosthetic voice restoration after total laryngectomy confronts ENT specialists with an increasing number of prosthesis-related complications. The ENT specialist should be familiar with the management of these complications in order to maintain the patients speech and social rehabilitation. In a retrospective study on 108 consecutive patients, complications were encountered in 30%. The incidence was not related to the factors age or primary vs. secondary insertion of the prosthesis. Complications consisted of formation of granulation tissue (15.7%), shunt dilatation (5.5%), loss of prosthesis (3.7%), local cellulitis (2.8%), extrusion (1.9%), ingrowth of prosthesis (1.9%) and formation of excessive scar tissue with dislocation of prosthesis (0.9%). Permanent removal of the prosthesis due to complications was necessary in 3 cases (2.8%). Therapeutic measures for the management of complications are described and evaluated. The treatment of complications was well tolerated by all patients and led to satisfying results in most cases. Our observations show that prosthetic voice rehabilitation is associated with various difficulties and complications, but that these can be handled quite easily and successfully in the majority of cases.