Long-Term Experiences of the Provox Voice Prosthesis at Snuh

서울대학교병원에서의 Provox 장기간 사용경험

Background and Objectives : Provox, a recently developed tracheoesophageal prosthesis, had been widely used for voice rehabilitation after total laryngectomy for its low resistance and easiness of speech ability. But, long-term use of Provox resulted in many complications and resulted in cessation of Provox as a primary method of vocal rehabilitation. The aim of this study is to report Provox-related problems and the long-term results of Provox voice prosthesis. Materials and Methods : Medical records from patients who had undergone total laryngectomy with Provox insertion at seoul National University Hospital between January 1993 and December 1998 were reviewed retrospectively. Results : 36 patients had used 79 Provox voice prostheses during the observed period. The most common complication causing prosthesis change or removal was leakage and/or aspiration, followed by granulation formation, crusting and/or obstruction, and non-function. Median in situ lifetime of Provox was 274 days and 1-year-in situ rate was 31.0% Among 36 patients, 17 patients had undergone tracheoesophageal shunt closure at the last follow-up visit. 10 patients had complications but got along without further treatments, and 1 patient changed to Blom-Singer voice prosthesis. Only 8 patients experienced no complication, and 5 out of whom had several times of Provox change. Conclusion : long-term use of Provox resulted in discontinuation of its use due to complications in many cases. A better voice prosthesis with lower complication rate and longer in situ lifetime is needed.