Average lifetime of voice prostheses in laryngectomized patients and influencing factors

The placement of a phonatory prosthesis is the reference treatment for phonatory rehabilitation in laryngectomised patients. These devices have a predetermined useful life and require periodic replacements, the frequency of which varies between patients and depends on various factors not yet clearly established. The objective of this study was to determine the factors related to the frequency of prosthesis changes as well as to describe the characteristics of the sample and the average useful life of the prostheses.

A retrospective multicentre study was conducted. The dependent variable was the number of annual replacements of speaking prostheses. Independent variables included age, sex, tumour location and staging, type of surgery (laryngectomy vs. pharyngolaryngectomy), timing of prosthesis placement (primary vs. secondary), and treatment with preoperative or postoperative chemoradiotherapy. A univariate (t-test, ANOVA) and multivariate (multiple linear regression) analysis was performed.

135 patients were included. The average useful life of the voice prosthesis was 115 days (3.15 replacements per year). In the multivariate analysis, the type of surgery was the only variable independently associated with the number of replacements (IC 95% = .16 - 2.05 replacements/year more in pharyngolaryngectomygroup; p = .02). No significant associations were observed with the time of placement of the prosthesis, chemoradiotherapy or with the rest of the factors analyzed.

The number of annual replacements was higher in patients with pharyngolaryngectomy. A trend was observed, bordering on statistical significance, towards a lower rate of annual replacements in patients whose prosthesis was inserted secondarily. None of the other factors analysed significantly influenced the durability of the prosthesis.