Practical Management of Periprosthetic Leakage in Patients Rehabilitated With a Provox® 2 Voice Prosthesis After Total Laryngectomy
| Autor: | Paloma Pinacho Martínez, Carlos Martin-Oviedo, Daniel Poletti Serafini, Tomás Martinez Guirado, Eviatar Friedlander, Bartolomé Scola Yurrita |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Fistula Periprosthetic Laryngectomy Tracheoesophageal fistula Prosthesis Design Prosthesis 03 medical and health sciences chemistry.chemical_compound Postoperative Complications 0302 clinical medicine Silicone medicine Humans 030223 otorhinolaryngology Aged Retrospective Studies business.industry General Medicine Middle Aged Voice prosthesis medicine.disease Surgery chemistry 030220 oncology & carcinogenesis Female Larynx Artificial business Complication |
| Zdroj: | Acta Otorrinolaringologica (English Edition). 67:301-305 |
| ISSN: | 2173-5735 |
| DOI: | 10.1016/j.otoeng.2015.12.003 |
| Popis: | Introduction and objectives Periprosthetic leakage of liquids is a common complication in patients rehabilitated with voice prostheses. Our objective was to describe and review the results of procedures for treating periprosthetic leakage. Materials and methods This was a retrospective analysis of 41 patients rehabilitated with Provox® 2 voice prostheses between 1997 and 2015. We describe 3 techniques: periprosthetic silicon collar placement, injection of hyaluronic acid into the tracheoesophageal wall and the combination of the 2 techniques. We present a method to reduce the diameter of the tracheoesophageal fistula by removing the voice prosthesis and placing a nasogastric tube through the fistula. Results In the 3 groups treated with silicone collar (n=5, 13 procedures), hyaluronic acid injection (n=5, 9 procedures) and the combination of both techniques (n=3, 5 procedures), we observed an increase in prosthesis lifespan of an average of 56 days (range 7–118 days), 32 days (range 3–55 days) and 63 days (range 28–136 days), respectively. The tracheoesophageal fistula diameter reduction was performed in 100% (n=6) of patients. Conclusions The use of silicone collars, injection of hyaluronic acid into the tracheoesophageal wall and the combination of both techniques for the treatment of periprosthesis leakage increase the lifespan of the prosthesis. Temporary prosthesis removal and placement of nasogastric tube has also been shown effective in our experience. These techniques are simple, inexpensive and reproducible, thereby reducing healthcare costs. |
| Databáze: | OpenAIRE |
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