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[Research solutions to find the conception of artificial larynx]
Philippe Schultz1, Anne Charpiot, Dominique Vautier
1Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, CHU de Hautepierre, Strasbourg Cedex, France. philippe.schultz@chrustrasbourg.fr
Objective:
The aim of this work is to present requirements and actual solutions to produce a laryngeal prosthesis.
Method:
Data were collected after a literature review and in the light of our work in that field.
Results:
The conception of an artificial larynx requires biocompatibility studies to find the ideal biomaterial capable of being integrated in cervical environment and upper airway tracts. A hollow tube extending the trachea, surrounded by cervical tissue, and covered with epithelium on the endoluminal part would allow connecting the trachea to the tongue base. The biomaterial should be rigid, inert, non cytotoxic, and smooth to fulfill the physical necessities of the implant and to optimize its tolerance and colonization. Among all biomaterials tested, porous titanium seems to be the most interesting. To prevent aspiration, the creation of a laryngeal sphincter located over the superior part of the hollow tube is required. An opening and closing system, coordinated to respiration and swallowing, could be considered with valves. In proportion to the unavoidable wear and tear of the mechanism, the conception of a removable sphincter seems necessary. Moreover, this system could harbour a phonatory valve to generate the fundamental laryngeal tone.
Conclusion:
Although any laryngeal sphincter is currently available, the biocompatibility studies already performed allow disposing of biomaterial to create a laryngeal prosthesis.
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