The Nijdam voice prosthesis: a self-retaining valveless voice prosthesis for vocal rehabilitation after total laryngectomy.

Voice prosthesis-assisted speech rehabilitation after total laryngectomy has proven to be successful in the majority of patients and exceeds the results of traditional oesophageal speech. Nevertheless 10-30% failure rates are still reported. In part this is due to prosthesis-related problems, in particular ingrowth of Candida species in the valve-bearing parts of the devices. A new indwelling, low-resistance and valveless voice prosthesis is described; the Nijdam voice prosthesis. The device has an average device lifetime of 19 weeks which appears to be superior to other indwelling voice prostheses. Replacement indications mainly comprise leakage or increased airflow resistance. Most frequent local complications are granulation tissue and hypertrophic scar tissue formation. These occur in 12% of the patients and can easily be treated. Replacement is a simple outpatient procedure. The prosthesis is interchangeable with other types of indwelling voice prosthesis.