Oropharynx decontamination preventing Candida vegetation on voice prostheses

Area of Science:

• Otolaryngology
• Medical Mycology
• Biomedical Engineering

Background:

• Candida yeast colonization of voice prostheses is a common issue in post-laryngectomy patients, leading to device dysfunction.
• Silicone voice prostheses are crucial for voice rehabilitation after laryngectomy.
• Yeast overgrowth can compromise the function and longevity of these essential devices.

Purpose of the Study:

• To evaluate the efficacy of selective oropharyngeal decontamination in reducing Candida yeast colonization.
• To assess the impact of this decontamination method on voice prosthesis and tracheoesophageal fistula yeast burden.
• To explore the potential of this intervention to prolong voice prosthesis device lifetime.

Main Methods:

• A study involving ten post-laryngectomy patients with Candida colonization.
• Administration of amphotericin B lozenges for selective oropharyngeal decontamination.
• Monitoring of oropharyngeal Candida concentrations and yeast colonization on voice prostheses and in the tracheoesophageal fistula.

Main Results:

• A significant reduction in oropharyngeal Candida concentrations was observed following amphotericin B treatment.
• A subsequent decrease in yeast colonization on voice prostheses and within the tracheoesophageal fistula was noted.
• The study suggests a potential for prolonged device lifetime through this decontamination strategy.

Conclusions:

• Selective oropharyngeal decontamination with amphotericin B is effective in reducing Candida yeast in the oropharynx of post-laryngectomy patients.
• This intervention can decrease yeast colonization on voice prostheses, addressing a key factor in device dysfunction.
• The findings suggest that this approach may extend the functional life of voice rehabilitation devices.