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Does prosthesis diameter matter? The relationship between voice prosthesis diameter and complications.
Heather M Starmer1, Nishant Agrawal, Wayne Koch
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA. hstarme1@jhmi.edu
Summary
Voice prosthesis diameter does not significantly impact complications after total laryngectomy. Prior radiation therapy, however, is linked to increased prosthesis issues and leakage in laryngectomy patients.
Area of Science:
- Otolaryngology
- Speech-Language Pathology
- Biomedical Engineering
Background:
- Tracheoesophageal voice prostheses are crucial for voice restoration after total laryngectomy.
- Understanding factors influencing voice prosthesis complications is essential for patient care.
Purpose of the Study:
- To evaluate the relationship between tracheoesophageal voice prosthesis diameter and prosthesis-related complications.
- To assess the influence of prior treatment (radiation/chemoradiation) on these complications.
Main Methods:
- A historical cohort study was conducted at a single academic medical institution.
- Patients undergoing total laryngectomy were grouped by prosthesis diameter (16F vs. 20/22F).
- Outcomes included time to leakage, leakage around the prosthesis, dislodgement, and length changes.
Main Results:
- No significant differences in leakage or dislodgement were found based on prosthesis diameter.
- Larger diameter prostheses were associated with more length changes (P = .008).
- Prior radiation was linked to increased size changes and decreased time to leakage (P < .05).
Conclusions:
- Prosthesis diameter does not appear to increase the risk of common voice prosthesis complications.
- Prior radiation or chemoradiation significantly correlates with increased prosthesis complications.
- Tissue health factors, not prosthesis size, may be the primary drivers of complications.
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