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Friday, January 6, 2017
Implantation of an Artificial Larynx in a Laryngectomee
Debry et el. from France reported (New England Journal of Medicine 2017; 376:97-98) the implanted for the second time an artificial larynx replacing laryngeal functions. The artificial larynx has two parts implanted in a two-phase procedure. The device contains a titanium tracheal prosthesis with a porous distal end to improve soft-tissue integration and a removable titanium open-ventilation cap that allows the continuous passage of air while protecting the patient’s airway from aspiration. The cap allows the patient to breathe and drink liquids. When the coughing the upper flap opens transiently allowing expulsion of bronchopulmonary secretions.
Following implantation the patient was able to speak at an intelligible whisper, and continued to use a tracheostomy cannula for 18 hours a day. During a 16 months follow-up stenosis did not occur and the device did not interfere with radiotherapy, and the tracheostomy cannula could be closed at will. The patient could breathe and expectorate through the upper airways and maintained adequate arterial blood hemoglobin saturation on ambient air. Additionally, he was able to swallow saliva, although occasional aspiration of food took place. The patient’s ability to smell was restored.