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Pharyngolaryngectomy with free jejunal autograft reconstruction and tracheoesophageal voice restoration: Indications for replacements, microbial colonization, and indwelling times of the Provox 2 voice prostheses.

Head & Neck 2011 August
BACKGROUND: The purpose of this prospective study was to investigate shunt-related and device-related complications and microbial colonization of voice prostheses in patients after pharyngolaryngectomy with jejunal autograft reconstruction in comparison to patients after standard laryngectomy.

METHODS: Nine patients after pharyngolaryngectomy with jejunal autograft reconstruction (group 1) and 14 patients after standard laryngectomy (group 2) equipped with the Provox(®) 2 voice prostheses were followed up over 2 years. Anamnestic data, documentation of shunt-related or device-related complications, the Provox(®) 2 indwelling time, and standard microbiological procedures of voice prostheses were used for analyses.

RESULTS: A total of 157 prostheses were replaced. No significant difference in mean prosthesis indwelling time (p = .45) was observed between group 1 (116 ± 114 days) and group 2 (129 ± 99 days). Patients with jejunal autograft reconstruction needed prosthesis replacements more frequently within the first 60 days after prosthesis insertion in comparison to patients after standard laryngectomy (p = .007). The main indication for replacement in both groups was the device leakage (group 1: 93.1%, group 2: 92.1%). Prostheses of group 1 were more often colonized with Staphylococcus aureus (p = .027) and Enterobacteriaceae (p = .015).

CONCLUSION: This study demonstrated that, in comparison with patients after standard laryngectomy, patients after jejunal autograft reconstruction have similar shunt-related and device-related complications and prosthesis indwelling times. Therefore, tracheoesophageal voice rehabilitation could be strongly recommended in these patients.

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