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. 2014 Jul;124(7):1585-91.
doi: 10.1002/lary.24488. Epub 2013 Dec 18.

Clinical application of the Provox NiD voice prosthesis: a longitudinal study

Jan S Lewin  1 , Martha A Portwood, Yijia Wang, Katherine A Hutcheson
Affiliations

Clinical application of the Provox NiD voice prosthesis: a longitudinal study

Jan S Lewin et al. Laryngoscope. 2014 Jul.

Abstract

Objectives/hypothesis: To evaluate the indications, complications, and device life of the Provox NiD in a large cohort at a tertiary US cancer center.

Study design: Longitudinal retrospective cohort study.

Methods: We reviewed the records of patients who used the NiD prosthesis (2005-2011) for general indicators, device life, and complications.

Results: One hundred eighty-six patients who used the NiD were included (median follow-up: 21.4 months). The NiD was placed at initial fit in 41 (22%) patients, whereas 145 (78%) tried an NiD after using another type of prosthesis. Most patients used the NiD similarly to an indwelling device. Median NiD device life was significantly longer than that of other nonindwelling prostheses (45 vs. 29 days, P=.0061), and did not significantly differ from that of standard indwelling devices (45 vs. 50 days, P=.4263). Thirty-eight percent (71 of 189) of NiD users had a history of early leakage (<8 weeks) using a different prosthesis before trying the NiD. Among patients with a pre-existing history of early leakage, almost 90% of NiD prostheses outperformed the device life of other products.

Conclusions: The NiD prosthesis offers satisfactory device life on a par with indwelling prostheses in our cohort of NiD users. Coupled with favorable published airflow characteristics and satisfactory tracheoesophageal voice, these data suggest that the NiD offers a durable, low-cost prosthetic alternative in contemporary practice. A unique indication for NiD may be improved device life in some patients with a history of early leakage.

Level of evidence: 4.

Keywords: Provox NiD; total laryngectomy; tracheoesophageal puncture; voice prosthesis.

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Conflict of interest statement

Conflicts of Interest: None

Figures

Figure 1
Figure 1
Indications for first NiD™ use. *immediate post-fit leak, patient's request, for independent placement, superior tract migration N = 186
Figure 2
Figure 2
NiD™ device life. Excludes prostheses customized or dislodged, and those replaced outside of MDACC N = 465
Figure 3
Figure 3
Flow chart. *not evaluable, replaced at home or outside hospital **indwelling use, clinician replaced at MDACC n = number of NiD™ prostheses contributing to device life calculations within strata
Figure 4
Figure 4
a. NiD™ device life stratified by indication for removal. Excludes prostheses customized or dislodged, and those replaced outside of MDACC N = 465 b. NiD™ device life stratified by acute and post-acute follow-up periods. Excludes prostheses customized or dislodged, and those replaced outside of MDACC N = 465
Figure 4
Figure 4
a. NiD™ device life stratified by indication for removal. Excludes prostheses customized or dislodged, and those replaced outside of MDACC N = 465 b. NiD™ device life stratified by acute and post-acute follow-up periods. Excludes prostheses customized or dislodged, and those replaced outside of MDACC N = 465
Figure 5
Figure 5
NiD™ device life compared with standard indwelling and other non-indwelling (not NiD™) prostheses. Excludes prostheses customized or dislodged, and those replaced outside of MDACC N = 1,382
Figure 6
Figure 6
Dimensions of the NiD™ prostheses.
See this image and copyright information in PMC

References

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