Voice prosthetic valve failure due to biofilm formation

Tracheoesophageal shunt speech is the most succesful method in rehabilitating speech in laryngectomized patients. The majority of these patients are capable of using this method already within a number of days after laryngectomy and the quality of speech is high compared to the esophageal speech and the use of an electrolarynx, as alternative methods of speech rehabilitation. However, the limited lifetime of silicone rubber voice prostheses is worrisome and has to be conquered since each replacement bears the risk of inducing damage to the tracheoesophageal fistula. Moreover, replacements are regarded as very unpleasant by patients and also lead to high costs. The formation of a biofilm, consisting of bacteria and yeasts, on the esophageal side of voice prostheses causes malfunctioning of the valve mechanism and is generally held responsible for this limited lifetime. Therefore, particularly in case of laryngectomized patients with voice prosthetic lifetimes less than 3 to 4 months, there is need for employing 'antibiofilm' therapy from the time of insertion of the voice prosthesis, preferably without using antimycotics or antibiotics because of the risk of inducing resistant strains. ...

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