silicon and Fistula

Vocal rehabilitation in laryngectomized patients can be attained by surgical (tracheoesophageal speech) or conservative methods (oesophageal speech or artificial larynx). We prospectively studied voice restoration in 37 patients who underwent total laryngectomy in the period from February 1991 to February 1993. The patients were given the opportunity to assess both non-shunt oesophageal speech and shunt oesophageal speech using the Provox voice prosthesis. The Provox low resistance, self-retaining voice prosthesis is a biflanged device made of silicon rubber. A primary tracheoesophageal puncture was made in 28 patients, while a secondary puncture was performed in another nine patients. The results were assessed according to criteria established at the 'Third International Congress on Voice Prosthesis' in Groningen (1988). Functional tracheoesophageal speech after primary puncture was achieved in 95% of patients 12 months after puncture, while oesophageal voice was acquired by 55%. Only minor surgical and prosthesis-related complications were encountered during this follow-up period in 29% of the patients. The device lifetime varied from 3 months to at least 2 years (mean 5.4 months).

Topics: Candida albicans; Female; Fistula; Humans; Laryngectomy; Larynx, Artificial; Male; Middle Aged; Prosthesis Failure; Retrospective Studies; Silicon; Speech, Alaryngeal; Staphylococcus aureus; Treatment Outcome; Voice Disorders; Voice Quality; Voice Training

The process of intra- and extra-hepatic fistula formation after percutaneous transhepatic cholangiodrainage (PTCD) was investigated. Furthermore, effects of such 4 materials of catheter as vinyl chloride, silicon, polyethylene and poly-urethane on this formation process were compared in order to clarify factors influencing the process. Fistula formation began 2 weeks after PTCD, and nearly completed after 4 weeks. A drainage fistula most markedly formed in the use of vinyl chloride, as the fistula wall was thick and its collagen fibers were microscopically observed to be dense and regularly arranged. On the other hand, fistula walls were thin, and their connective tissues consisted of immature cells and sporadically observed, when the other materials were used. However, degeneration of the liver cells around the intrahepatic fistula was most markedly seen in the use of vinyl chloride. In addition, the fistula formation tended to be more facilitated at early stage when the extrahepatic bile duct was occluded. These results suggested that vinyl chloride is the most suitable material if the drainage is applied for the fistula formation.

Topics: Animals; Biliary Tract Surgical Procedures; Catheterization; Drainage; Fistula; Polyethylenes; Polyurethanes; Rabbits; Silicon; Vinyl Chloride

Topics: Cholesteatoma; Ear Canal; Ear Neoplasms; Ear Ossicles; Fistula; Humans; Labyrinth Diseases; Mastoid; Methods; Mucous Membrane; Neoplasm Recurrence, Local; Otitis Media; Postoperative Complications; Semicircular Canals; Silicon; Tympanoplasty

Topics: Body Fluids; Fistula; Humans; Silicon; Skin