Sayed Sushail I, Datta Sourav, Deore Nitin, Kazi Rehan A, Jagade Mohan V
Department of ENT and Head & Neck Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai 400008.
J Indian Med Assoc. 2012 Mar;110(3):175-8, 180.
Voice rehabilitation after a total laryngectomy is an important requisite for patients' rehabilitation. Oesophageal speech using tracheo-oesophageal-valved prostheses is now considered the state-of-art in postlaryngectomy voice rehabilitation. One of the major drawbacks of voice prostheses is their limited device lifetime. This is due to the deterioration of the silicone rubber material by different bacterial and yeast species, which are organised in the form of a biofilm resulting in internal leakage, increased airflow resistance, impeding speech, respiration and swallowing. The use of antimicrobials though easily applicable is associated with development of resistance if used on long-term basis. Other techniques in the form of modification of physicochemical properties of the silicon surface or covalent binding of antimicrobial agents to the silicon surface have been employed. This article reviews the different strategies investigated until now and the future trends in preventing biofilm formation for prolonging the lifetime of the silicon voice prostheses. Data was collected by conducting a computer aided search of the MED-LINE and PUBMED databases, supplemented by hand searches of key journals. Over 35 articles in the last two decades on the topic have been reviewed out of which 27 were found to be of relevant value for this article.
全喉切除术后的嗓音康复是患者康复的一项重要要求。使用带瓣膜的气管食管假体进行食管发音目前被认为是喉切除术后嗓音康复的先进技术。嗓音假体的一个主要缺点是其装置寿命有限。这是由于不同细菌和酵母种类使硅橡胶材料变质，这些微生物以生物膜的形式存在，导致内部泄漏、气流阻力增加，从而妨碍言语、呼吸和吞咽。虽然使用抗菌剂很容易操作，但长期使用会产生耐药性。也采用了其他技术，如改变硅表面的物理化学性质或使抗菌剂与硅表面共价结合。本文综述了迄今为止所研究的不同策略以及防止生物膜形成以延长硅制嗓音假体寿命的未来趋势。通过对MEDLINE和PUBMED数据库进行计算机辅助检索收集数据，并辅以对主要期刊的手工检索。对过去二十年中关于该主题的35篇以上文章进行了综述，其中27篇被认为对本文具有相关价值。
