Estimation of Benefit From Regular Versus Leakage-related Exchange of Voice Prosthesis in Patients Post Laryngectomy.

NCT ID: NCT04268459

Last Updated: 2020-02-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-03-10

Study Completion Date

2022-03-31

Brief Summary

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The tracheoesophageal voice with voice prosthesis is currently the mainstay of voice rehabilitation post laryngectomy. The primary surgical technique of tracheoesophageal fistula formation with insertion of prosthesis and quick and easy process of voice rehabilitation are main encouraging factors. However, the usage of the prosthesis relates to a significant number of complications rated from 10 to 60%. The most common reported complication is transprosthetic leakage that determines the need of device exchange. However in some patients occur more serious complications eg. periprosthetic leakage, granulation or atrophy of mucosa around the fistula, dislocation of prosthesis, that may require anti-inflammatory treatment, temporary nasogastric tube feeding or surgical procedure. The standard protocol is voice prosthesis exchange due to transprosthetic leakage. Optionally the device could be replaced regularly to prevent both transprosthetic leakage and other complication occurrence.

In the study we plan to compare the benefits from regular (each three month) versus leakage-related exchange of voice prosthesis post laryngectomy including the rate of complications, fistula colonization by Candida species and patients feedback.

Detailed Description

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Conditions

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Laryngectomy Voice Prosthesis Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

randomized controlled trial
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Regular exchange

Patients will be appointed each 3 months for regular exchange of voice prosthesis.

Group Type ACTIVE_COMPARATOR

Provox prosthesis exchange

Intervention Type DEVICE

Each patient post laryngectomy will be randomly assigned to one arm of intervention. The voice prosthesis exchange in all patients will be performed in local anaesthesia. The microbiological samples with cotton swabs will be collected from tracheoesophageal fistula on prosthesis exchange. The clinical evaluation and patients satisfaction from prosthesis usage will be performed on each exchange.

Leakage exchange

Patients will have voice prosthesis exchange when leakage occurs.

Group Type ACTIVE_COMPARATOR

Provox prosthesis exchange

Intervention Type DEVICE

Each patient post laryngectomy will be randomly assigned to one arm of intervention. The voice prosthesis exchange in all patients will be performed in local anaesthesia. The microbiological samples with cotton swabs will be collected from tracheoesophageal fistula on prosthesis exchange. The clinical evaluation and patients satisfaction from prosthesis usage will be performed on each exchange.

Interventions

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Provox prosthesis exchange

Each patient post laryngectomy will be randomly assigned to one arm of intervention. The voice prosthesis exchange in all patients will be performed in local anaesthesia. The microbiological samples with cotton swabs will be collected from tracheoesophageal fistula on prosthesis exchange. The clinical evaluation and patients satisfaction from prosthesis usage will be performed on each exchange.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* patients post laryngectomy with primary insertion of voice prosthesis

Exclusion Criteria

* patients post laryngopharyngectomy with digestive tract reconstruction with jejunum of free flap
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University of Warsaw

OTHER

Sponsor Role lead

Responsible Party

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Anna Rzepakowska

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Anna Rzepakowska, PhD

Role: STUDY_CHAIR

Medical University of Warsaw

Locations

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Department of Otorhinolaryngology, Head andNeck Surgery of Medical University of Warsaw

Warsaw, , Poland

Site Status

Countries

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Poland

Central Contacts

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Anna Rzepakowska, PhD

Role: CONTACT

+48225992521

Daniel Majszyk, PhD

Role: CONTACT

+48225992521

Facility Contacts

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Anna Rzepakowska, PhD

Role: primary

+48225992521

Ewa Osuch-Wójcikiewicz, Professor

Role: backup

+48225992521

References

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Zurek M, Czesak M, Majszyk D, Rzepakowska A. Benefit from regular versus leakage-related exchange of voice prostheses in patients post-laryngectomy considering complication rates and patient satisfaction feedback-a randomized case-controlled trial. Front Oncol. 2025 Jan 24;15:1468955. doi: 10.3389/fonc.2025.1468955. eCollection 2025.

Reference Type DERIVED
PMID: 39926276 (View on PubMed)

Zurek M, Czesak M, Czerwinska ME, Berezovska D, Niemczyk K, Rzepakowska A. A double-blind randomized clinical trial of inflammatory cytokine and pepsin levels in the saliva of patients with voice prostheses. Head Neck. 2024 Sep;46(9):2116-2122. doi: 10.1002/hed.27847. Epub 2024 Jun 12.

Reference Type DERIVED
PMID: 38864228 (View on PubMed)

Other Identifiers

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1WF_CT_1_2020

Identifier Type: -

Identifier Source: org_study_id

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