Vocal rehabilitation by voice prosthesis after total (pharyngo)laryngectomy: A STROBE study

To evaluate the criteria used by surgeons to select tracheoesophageal voice (TEV) rehabilitation by voice prosthesis (VP) after total laryngectomy (TL) or pharyngolaryngectomy (TPL).

This was a retrospective study conducted in a tertiary referral center between January 2014 and December 2023. The primary objective was to assess the selection criteria for TEV rehabilitation with VP after TL or TPL. Secondary objectives were to analyze VP longevity, related complications, and factors influencing their occurrence. The STROBE reporting guidelines were followed, and the significance threshold was set at P<0.005.

A total of 114 patients who underwent TL, TPL or circular TPL were included, 53 of whom received a VP. On binomial logistic regression, patients who underwent TEV rehabilitation with VP were younger (P=0.020), had better general health status (ASA>2, P<0.001), and underwent surgery with direct closure (P=0.026). Median VP lifespan was 188days [IQR: 124-305]. Periprosthetic leakage was the most frequent complication (75% of all complications).

TEV rehabilitation tended to be proposed to younger patients in good general health and in cases other than salvage surgery. Patients should be assessed preoperatively before determining the method of voice rehabilitation.