Response to the letter to the editor from Hilgers FJM, van den Brekel MWM, van Tinteren H regarding Acton, et al, Investigation of tracheoesophageal voice prosthesis leakage patterns: Patient self-report versus clinician's confirmation

✍ Scribed by Lynn M. Acton; Douglas A. Ross; Clarence T. Sasaki; Steven B. Leder

• Book ID: 102235667
• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 58 KB
• Volume: 30
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.20954

✦ Synopsis

We feel bound to respond to the paper ''Investigation of tracheoesophageal voice prosthesis leakage patterns: Patient's self-report versus clinician's confirmation'' by Acton et al. 1 In this paper, the authors presented a prospective study in 66 laryngectomized patients, who in 200 instances visited the clinic for a ''patient-initiated reason for prosthesis change.'' The authors drew 2 conclusions: ''Patient education is important for reliable identification of leakage for prompt prosthesis replacement,'' and ''Leakage around the voice prosthesis can be minimized or avoided by initially fitting and continuing the use of smaller diameter (16Fr) voice prostheses.''

The first conclusion is substantiated by the data and the statistics showing a significantly more frequent absence of cough reflex in patients, who are seen in the clinic with leakage around the prosthesis. Therefore, patients with leakage around are less frequently identifying this problem themselves and are more prone to aspiration pneumonia. This is an important finding, which has clinical relevance and fully justifies the first conclusion of the authors.

The second recommendation, however, is not at all supported by the data presented. Apart from