ORIGINAL RESEARCH article
Front. Oncol.
Sec. Head and Neck Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1566697
Benefits of prophylactic voice prosthesis replacement -a retrospective study
Provisionally accepted
Sławomir Okła1,2*
Jakub Spałek1,2
Szczepan Kaliniak1
Agnieszka Strzelecka2Michał Chrobot1Michiel Van Den Brekel3
Stanislaw Gozdz1,2- 1Holy Cross Cancer Center, Kielce, Poland
- 2Institute of Medical Sciences, Jan Kochanowski University, Kielce, Świętokrzyskie, Poland
- 3The Netherlands Cancer Institute, Amsterdam, the Netherlands., Amsterdam, Netherlands
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In this retrospective, single centre study made at the regional cancer centre we have analysed whether prophylactic voice prosthesis replacement (PVPR) could reduce the occurrence of tracheoesophageal fistula (TEF) dysfunction. We have reviewed 2.431 cases of voice prosthesis (VP) replacement procedures performed in 327 patients between January 2017 and December 2022 at the Department of Otolaryngology, Head and Neck Surgery, Holy Cross Cancer Centre, Kielce, Poland. In the middle of this period (January 2020), the management of VP replacements was changed from reactive, unscheduled voice prosthesis replacement (UVPR), with a median device lifetime of 7 months to prophylactic, scheduled replacement (PVPR) procedures occurring every 3 months. The statistical analysis confirmed a significantly lower number of complications during the period of PVPR (2020-2022) compared to the previous period of UVPR (2017-2019). In the years 2017-2019, out of a total of 911 voice prosthesis replacements performed in 246 patients, 425 were associated with complications related to TEF (47%). In comparison, in the years 2020-2022 (following the introduction of PVPR), only 91 cases (6%) (p < 0.001; r = 0.408) out of 1520 voiceprosthesis exchanges performed in 250 patients had related TEF complications. The types of and occurrence of TEF complications remained the same in both time intervals (UVPR vs PVPR), with the most common widening of the fistula tract being seen in 80% and 78% of all TEF complications, respectively. PVPR every 3 months can reduce fistula complications compared to a protocol with reactivereplacement for voice prosthesis or TEF dysfunction.
Keywords: voice prosthesis (VP), prophylactic VP replacement, TE fistula widening, Device lifetime, complication, Laryngectomy, Biofilm formation
Received: 25 Jan 2025; Accepted: 26 May 2025.
Copyright: © 2025 Okła, Spałek, Kaliniak, Strzelecka, Chrobot, Van Den Brekel and Gozdz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sławomir Okła, Holy Cross Cancer Center, Kielce, Poland
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