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Complications following secondary voice prosthesis insertion and impact of previous irradiation on their appearance
D M Dragicevic1, R M Jovic1, V L Kljajic1
1Faculty of Medicine, University of Novi Sad; Clinical Centre of Vojvodina, Clinic for Otorhinolaryngology and Head and Neck Surgery, Novi Sad, Serbia.
Objective:
The aim of this study was to analyze the complications following secondary voice prosthesis insertion and impact of previous irradiation on their appearance.
Methods:
This study included 106 totally laryngectomized patients who underwent secondary Provox 2 voice prosthesis insertion. Among them, 79 (74.5%) were irradiated. Surgery, prosthesis, fistula, and voice-related complications were analyzed and presented.
Results:
Complications occurred in 23 (22%) patients. Fifteen of them were previously irradiated. There were no surgery-related complications. In the group of prosthesis-related complications, one patient had increased negative pressure during swallowing with extremely short prosthesis life time. There were 17 complications in the group of fistula related ones; 3 patients had excessive granulation tissue around the fistula and 14 patients experienced prosthesis displacement (7 had closed esophageal end of the fistula, 5 had the prosthesis turned sideways in an open fistula, one patient inhaled and one ingested the prosthesis). Tracheoesophageal voice was not established in 5 patients. Previous irradiation had no statistically significant influence on the complication rate (P = 0,251).
Conclusions:
The majority of complications following secondary voice prosthesis insertion are fistula-related ones, among which, displacement of the voice prosthesis is the most common. Previous irradiation does not significantly increase the risk of developing complications.
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