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.
Artificial Larynx
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