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[含氧化银瓣阀的语音假体(Blom-Singer Advantage)的临床应用、生物膜形成、原位使用寿命及适应证]

[Clinical use of a voice prosthesis with a flap valve containing silver oxide (Blom-Singer Advantage), biofilm formation, in-situ lifetime and indication].

作者信息

Kress P, Schäfer P, Schwerdtfeger F-P

机构信息

HNO-Klinik, Mutterhaus der Borromäerinnen Trier.

出版信息

Laryngorhinootologie. 2006 Dec;85(12):893-6. doi: 10.1055/s-2006-925292. Epub 2006 Apr 10.

Abstract

BACKGROUND

Fungal growth and the resulting leakage through an indwelling voice prosthesis remains the most frequent reason of prosthesis failure and renewal. In some patients leakage caused by fungal growth occurs in very short intervals (below 12 weeks in-situ lifetime) and causes frequent treatments and high costs.

METHODS

The Blom-Singer(R) Advantage voice prosthesis is a new prosthesis type with a modified flange design, a flap valve containing 7 % silver oxide in the silicon matrix and is expected to be resistant against biofilm formation and fungal growth.

PATIENTS

In a clinical trial we used the Blom-Singer(R) Advantage prosthesis in 33 patients with short in-situ lifetimes of their voice prosthesis and analysed the effects on in-situ lifetime and complications statistically.

RESULTS

The clinical use of the Blom-Singer(R) Advantage prosthesis was similar to other types of indwelling voice prosthesis (Provox(R) II, Blom-Singer Indwelling(R)) and did not cause any special problems. Prosthesis specific side effects (i. e. allergy against silver oxide) did not occur. Statistical analysis of the aquired data showed an interindividually changing, but significantly longer in-situ lifetime for the Blom-Singer(R) Advantage prosthesis. The mean device lifetime increased from 36 days (median 36 days) to a mean lifetime of 110 days (median 87 days) with the use of the Blom-Singer(R) Advantage prosthesis.

CONCLUSIONS

Using a voice prosthesis with a valve containing silver oxide can normalize and even increase the in-situ lifetime in patients with frequent changing procedures caused by fungal growth on the valve. Therefore we recommend the use of this type of voice prosthesis for those patients as reduction of costs and effort results.

摘要

背景

真菌生长以及由此导致的通过植入式语音假体的渗漏仍然是假体失效和更换的最常见原因。在一些患者中,由真菌生长引起的渗漏发生间隔非常短(原位使用寿命低于12周),导致频繁治疗和高昂费用。

方法

Blom-Singer® Advantage语音假体是一种新型假体,其凸缘设计经过改良,瓣膜含有7%氧化银的硅基质,有望抵抗生物膜形成和真菌生长。

患者

在一项临床试验中,我们对33例语音假体原位使用寿命短的患者使用了Blom-Singer® Advantage假体,并对原位使用寿命和并发症的影响进行了统计学分析。

结果

Blom-Singer® Advantage假体的临床使用与其他类型的植入式语音假体(Provox® II、Blom-Singer Indwelling®)相似,未引起任何特殊问题。未出现假体特异性副作用(即对氧化银过敏)。对所得数据的统计分析表明,Blom-Singer® Advantage假体的原位使用寿命在个体间有所变化,但显著延长。使用Blom-Singer® Advantage假体后,平均装置寿命从36天(中位数36天)增加到平均110天(中位数87天)。

结论

对于因瓣膜上真菌生长导致更换程序频繁的患者,使用含氧化银瓣膜的语音假体可使原位使用寿命正常化甚至延长。因此,我们建议为这些患者使用此类语音假体,以降低成本和减少工作量。

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