Total laryngectomy has a profound impact on the life of a patient. The loss of the larynx creates a major communication problem that can result in disruption of the patients normal pattern of social interaction. It is for this reason that adaptation to the loss of normal speech has been the focus of research on the rehabilitation of laryngectomized patients. Tracheoesophageal puncture and induction of the voice prosthesis have very well results in rehabilitation of the voice. The long terms clinical results obtained by experience with any of the complication are described. We use 4 types of voice prosthesis (Provox, Blom-Singer, Bivona Colorado and Czech prosthesis). We have very good experiences with system Provox. Our collection of the patients with Provox prostheses are 53 patients after total laryngectomy. All tracheoesophageal punctures were done in second time. Over 85% patients were able to produce satisfying voice. Speech quality was evaluated by Robe scale. 38.9% of them can speak fluently, which corresponds with a category F. Local inflammatory reaction occurred in 28.1% that resulted in extrusion or removal of voice prostheses in 14.2% patients. Use of voice prostheses in rehabilitation of laryngectomized patients occupies a significant place.

Klinika otorinolaryngologie a chirurgie hlavy a krku 1 lékarské fakulty Univerzity Karlovy a Vseobecné fakultní nemocnice Praha Czech Republic