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Informing patient choice and service planning in surgical voice restoration: valve usage over three years in a UK head and neck cancer unit

Published online by Cambridge University Press:  09 December 2021

K McLachlan ,
A Hurren ,
S Owen  and
N Miller
K McLachlan
Affiliation:
Head and Neck Oncology, St John's Hospital, NHS Lothian, Livingston, Scotland, UK
A Hurren*
Affiliation:
Speech and Language Sciences, Leeds Beckett University, UK
S Owen
Affiliation:
Speech and Language Sciences, Newcastle University, Newcastle Upon Tyne, UK
N Miller
Affiliation:
Speech and Language Sciences, Newcastle University, Newcastle Upon Tyne, UK
*
Author for correspondence: Dr A Hurren, Speech and Language Sciences, CL411, Leeds Beckett University, City Campus, Calverley Building, LeedsLS1 3HE, UK E-mail: a.hurren@leedsbeckett.ac.uk
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Abstract

Objective

This study aimed to determine the number, reasons and costs of surgical voice restoration related tracheoesophageal valve attendances over 36 months at a head and neck oncology unit.

Method

Demographic, medical and valve related details from all patient contacts were recorded, including self-change information, urgent appointment information, modifications required and costs of prostheses.

Results

Over 3 years, 99 patients underwent 970 valve changes. The main reasons for changes were central leakage, prophylactic change and self-change at home. Changes were significantly more frequent in the first 12 months (mean, 42 days) compared with longstanding patients (mean, 109.96). Intervals between changes were unpredictable; no predictive factors reached statistical significance. Mean expenditure on valves was £966.63 per week (including value added tax and in-house customisation).

Conclusion

Valve lifespan is comparable with outcomes in similar units despite more pre-emptive and patient-led changes and more comprehensive data inclusion. Investigation into how patient satisfaction and costs relate to valve selection and units’ service delivery models is needed.

Keywords

LaryngectomySpeechAlaryngealLarynxArtificialHead And Neck Neoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 2 , February 2022 , pp. 158 - 166
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Kirsty McLachlan takes responsibility for the integrity of the content of the paper

References

Clarke, P, Radford, K, Coffey, M, Stewart, M. Speech and swallow rehabilitation in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016;130:S176–80CrossRefGoogle ScholarPubMed
Royal College of Speech and Language Therapists, UK. Prosthetic surgical voice restoration (SVR): the role of the speech and language therapist. In: https://www.rcslt.org/wp-content/uploads/media/Project/RCSLT/svr-policy-document.pdf [28 October 2021]Google Scholar
Lewin, JS, Baumgart, LM, Barrow, MP, Hutcheson, KA. Device life of the tracheoesophageal voice prosthesis revisited. JAMA Otolaryngol 2017;143:65–71Google ScholarPubMed
Elliot, A. Prosthetic voice rehabilitation following laryngectomy: it's the archer not the arrow. JAMA Otolaryngol 2017;1:72Google Scholar
Bradley, PJ, Counter, P, Hurren, A, Cocks, HC. Provision of surgical voice restoration in England: questionnaire survey of speech and language therapists. J Laryngol Otol 2013;127:760–7CrossRefGoogle ScholarPubMed
Petersen, JF, Lansaat, L, Timmermans, AJ, van der Noort, V, Hilgers, FJM, van den Brekel, MWM. Postlaryngectomy prosthetic voice rehabilitation outcomes in a consecutive cohort of 232 patients over a 13-year period. Head Neck J Sci Spec 2019;41:623–31CrossRefGoogle Scholar
Kress, P, Schäfer, P, Schwerdtfeger, FP, Rösler, S. Are modern voice prostheses better? A lifetime comparison of 749 voice prostheses. Eur Arch Otorhinolaryngol 2014;271:133–40CrossRefGoogle Scholar
Starmer, HM, Ishman, SL, Flint, PW, Bhatti, NI, Richmon, J, Koch, W et al. Complications that affect postlaryngectomy voice restoration: primary surgery vs salvage surgery. Arch Otolaryngol 2009;135:1165–9CrossRefGoogle ScholarPubMed
Owen, S, Paleri, P. Laryngectomy rehabilitation in the United Kingdom. Curr Opin Otolaryngol 2013;21:186–91CrossRefGoogle ScholarPubMed
Miller, A. A laryngectomy consumables audit. Bull Royal Lang Speech Lang Therapists 2010;16–17Google Scholar
Chakravaty, PD, McMurran, AEL, Banigo, A, Shakeel, M, Ah-See, KW. Primary versus secondary tracheoesophageal puncture: systematic review and meta-analysis. J Laryngol Otol 2018;132:14–21CrossRefGoogle Scholar
Mayo-Yáñez, MI, Cabo-Varela, L, Dovalo-Carballo, C, Calvo-Henríquez, A, Martínez-Morán, A, Herranz González-Botas, JH. Provox 2® and Provox Vega® influential factors and duration. Eur Arch Otorhinol 2018;275:1827–30CrossRefGoogle ScholarPubMed
Yenigun, A, Eren, SB, Ozkul, MH, Tugrul, S, Meric, A. Factors influencing the longevity and replacement frequency of provox voice prostheses. Singap Med J 2015;56:632–6CrossRefGoogle ScholarPubMed
Krishnamurthy, A, Khwajamohiuddin, S. Analysis of factors affecting the longevity of voice prosthesis following total laryngectomy with a review of literature. Indian J Surg Oncol 2018;9:39–45CrossRefGoogle ScholarPubMed
Hancock, K L, Lawson, N. R., Ward, NR, EC. Device life of the Provox Vega voice prosthesis. Eur Arch Otorhinolaryngol 2013;270:1447–53CrossRefGoogle ScholarPubMed
Op de Coul, BMR, Hilgers, FJM, Balm, AJM, Tan, IB, van den Hoogen, FJA, van Tinteren, H. A decade of postlaryngectomy vocal rehabilitation in 318 patients. Arch Otolaryngol 2000;126:1320–8CrossRefGoogle ScholarPubMed