Larynx Replacement by a Device after Total Laryngectomy: Initial Clinical Experience, Future Steps

Objectives:To present the first cases of laryngeal rehabilitation by an artificial larynx performed after a total laryngectomy. The prosthesis aims at proposing an alternative to laryngeal transplantations and to techniques of tissular engineering and/or transplants by free fragments, used essentially in tracheal reconstructions.Methods:The artificial larynx was developed thanks to fundamental biomaterial research and long-term animal experiments. The insertion is a 2-stage procedure. The first step, performed immediately after the total laryngectomy, consists of connecting the trachea with a hollow titanium tube. After a 6-week period of healing, or 3 months after radiotherapy, a swallowing valve is fixed over the integrated titanium tube (second step).Results:Four patients have been treated (2 whole prosthesis, 2 partial prostheses) from June to December 2012. Two patients were able to talk in a whispering fashion while the tracheostomy was temporarily closed; their functioning in the relevant postopera...