180 | Chapter 7 Table 1. Continued No. of patients (%) Pharyngectomy No (standard laryngectomy) 137 (71%) Near-total 37 (19%) Circumferential 17 (9%) Unknown 3 (2%) Neck dissection during TL No 49 (25%) Unilateral during TL 48 (25%) Bilateral during TL 95 (49%) Unknown 2 (1%) Reconstruction No (primary closure) 124 (64%) Yes** 67 (34%) Unknown 3 (2%) Abbreviations: TL= total laryngectomy, *18 of these patients underwent salvage TL for a dysfunctional larynx, ** Varying reconstruction methods were used: Pectoralis major muscle (n=49), Free radial forearm flap (n=8), Gastric pull-up (n=7), Antero-lateral thigh flap (n=2), Latissimus dorsi flap (n=1). Voice prostheses The 194 patients used 3265 VPs in total during this study period. VPs with in situ times of less than one day (n=92), VPs of an unknown type (n=25), and VPs replaced for developmental study purposes VPs (n = 86) were excluded, leaving 3062 VPs for analysis. Device lifetime The median device lifetime of all VPs (N=3062) was 69 days. The median number of used VPs per patient per year was 3.4 (range 0.2 – 48.1). Of the 194 patients, 125 used only regular VPs (VPG1), and 69 used both regular and problem-solving VPs (VPG2). The median device lifetime of regular VPs in VPG1 67 days, and in VPG2 is 57 days. This difference was found to be significant (Mann-Whitney-U, p<0.05). The longevity of problem-solving VPs is two-and-half times longer than regular VPs, namely 168 days.
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