Rodrigues Lígia, Banat Ibrahim M, Teixeira José, Oliveira Rosário
Centro de Engenharia Biológica, Universidade do Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
J Biomed Mater Res B Appl Biomater. 2007 May;81(2):358-70. doi: 10.1002/jbm.b.30673.
Total laryngectomy, a surgical treatment for extensive cancer of larynx, which alters swallowing and respiration in patients, is followed up with a surgical voice restoration procedure comprising tracheoesophageal puncture techniques with insertion of a "voice prosthesis" to improve successful voice rehabilitation. However, microbial colonization is a major drawback of these devices. Antimicrobials are usually used to prevent the colonization of silicone rubber voice prostheses by microorganisms. However, long-term medication induces the development of resistant strains with all associated risks and the development of alternative prophylactic and therapeutic agents, including probiotics and biosurfactants, have been suggested. The inhibition of microbial growth on surfaces can also be achieved by several other techniques involving the modification of physicochemical properties of the biomaterial surface or the covalently binding of antimicrobial agents to the biomaterial surface. An overview of the different approaches investigated to date and future perspectives to reduce the frequent replacements of voice prostheses in laryngectomized patients through microbial biofilm retardation is presented and discussed.
全喉切除术是治疗广泛喉癌的一种外科手术，会改变患者的吞咽和呼吸功能，术后需进行手术语音恢复程序，包括采用气管食管穿刺技术并插入“语音假体”，以提高语音康复的成功率。然而，微生物定植是这些装置的一个主要缺点。抗菌药物通常用于防止微生物在硅橡胶语音假体上定植。然而，长期用药会诱导耐药菌株的产生以及所有相关风险，因此有人建议开发替代的预防和治疗药物，包括益生菌和生物表面活性剂。通过改变生物材料表面的物理化学性质或使抗菌剂与生物材料表面共价结合等其他几种技术，也可以实现对表面微生物生长的抑制。本文介绍并讨论了迄今为止所研究的不同方法的概述以及未来通过延缓微生物生物膜形成来减少喉切除患者语音假体频繁更换的前景。
