Abstract
After laryngectomy, the tracheostoma forms a functional center for breathing and phonation.
Form, size and position of the tracheostoma affect the quality of the tracheoesophageal
voice. A rare but absolutely typical problem arises from a large and irregularly formed
tracheostoma making a sufficient mechanical closing difficult or rather impossible.
As an alternative to surgical correction of such a dysmorphic tracheostoma we inserted
individually adjusted tracheostoma silicon prosthesis. In this study comprising 21
patients, the subjective assessment of voice quality and breathing function was monitored
by a standardized interview as well as the Voice Handicap Index (VHI). Additionally,
7 patients were evaluated clinically. Compared to the standard speech silicon canula
a significant improvement of voice function (prolonged voice production and less peristomal
noise) was achieved using the tracheostoma prosthesis without increasing airway resistance
during breathing. Besides, there was a close correlation between self-evaluation and
total VHI score. Light local skin reactions were described by 1/4 of the patients
caused by the applied medical adhesive. In general the prosthesis was used 20 hours
by the patients, its durability (loss of elasticity, discoloration) was estimated
to 2 years. According to our experience, the tracheostoma silicon prosthesis represents
an effective alternative to a surgical revision of a dysmorphic tracheostoma after
laryngectomy.
