Cases reported "Prosthesis Failure"

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1/4. Unusual complication of surgical voice restoration.

    A case of oesophageal obstruction following the removal of a tracheoesophageal valve by division is presented. The obstruction was caused by impaction of a portion of the valve at a previously undiscovered benign oesophageal stricture. The obstruction was resolved by interventional radiology with no long-term sequelae. To the best of our knowledge this complication has not been described previously.
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ranking = 1
keywords = voice
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2/4. Therapy of periprosthetical leakage with tissue augmentation using Bioplastique around the implanted voice prosthesis.

    Having a voice prosthesis provides a good possibility for speech rehabilitation after total laryngectomy has been performed, especially if common complications such as leakage around the valve can be reduced effectively. The early applications of a voice prosthesis-which was originally invented and applied by Mozolewski in 1972, was further developed by Blom and Singer and became an internationally available implantable instrument by 1980- already made clear not only the typical benefits, but also the complications, such as possible leakage around the implanted valve. Remacle proposed the injection of collagen into the surrounding tissues in order to stop leakage. Knowing that collagen is usually resorbed as time goes by, new substances that can be tolerated by human tissues must be found. This article reports the experiences of the authors in the search for such an injectable material that cannot be resorbed and does not migrate. In order to solve the above-mentioned problem, Lichtenberger introduced the injection of Bioplastique into the perivalvular tissues. This delivered the best results ever achieved in this field at our department. During the past 2 years, Bioplastique augmentation was performed for seven laryngectomized and speech-rehabilitated patients in order to reduce periprosthetical leakage. All procedures were successful in terms of either eliminating or reducing the leakage, and also the non-resorbable property of Bioplastique has been proven.
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ranking = 1.5
keywords = voice
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3/4. Analysis of failure of voice production by a sound-producing voice prosthesis.

    OBJECTIVE: To analyse the cause of failing voice production by a sound-producing voice prosthesis (SPVP). methods: The functioning of a prototype SPVP is described in a female laryngectomee before and after its sound-producing mechanism was impeded by tracheal phlegm. This assessment included: perceptual voice evaluation of read-aloud prose by an expert listener; inspection of the malfunctioning SPVP; and aero-acoustical in vivo registrations using a computer-based data acquisition system. RESULTS: sound-producing voice prosthesis speech is higher pitched, stronger, contains less aperiodic noise and requires a lower airflow rate than the patient's regular tracheoesophageal (TE) shunt speech. Tracheal phlegm caused malfunction of the vibrating silicone lip of the SPVP by causing it to stick to its stainless steel container in an opened position, thereby reducing the SPVP to no more than a regular TE shunt valve from a functional point of view. Tracheal phonatory pressure and dynamic vocal intensity range were not affected by the functional status of the SPVP. CONCLUSIONS: To exploit the advantages an SPVP could offer female laryngectomees with an atonic or severely hypotonic pharyngoesophageal segment, the sound-producing mechanism of the SPVP needs to be less vulnerable to tracheal phlegm.
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ranking = 3
keywords = voice
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4/4. Hypertrophic scarring of tracheoesophageal fistula causing vocal failure.

    There are many known complications of tracheoesophageal puncture for voice restoration. A patient developed hypertrophic scarring with subsequent vocal failure, an as yet unreported complication.
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ranking = 0.25
keywords = voice
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