Microbial Colonization Of Groningen Voice Prostheses And The Diet Related To The Lifetime Of The Voice Prostheses

【objective】Using silicone rubber voice prostheses to rehabilitate the lost voiceof patients after total laryngectomy which has high success, good qulitation ofspeech and easy operative process has been accepted by more and more patients.However, the silicone voice prostheses rapidly will been colonized with a mixedbiofilm of bacteria and yeasts, when inserted into the tracheoesophageal shunt.The formation of the biofilm, the consequent material deterioration and thefollowed dysfunction of the voice prostheses, which is the main reasondetermining the lifetime of the voice prostheses. To prolong the lifetime of thesilicone voice prostheses, since the first description of biofilms on voiceprostheses, a large number of different microbial species have been isolated byvarious groups from voice prosthetic biofilms. Many methods to prolong thelifetime of voice prostheses have been suggested. The use of silicone voiceprostheses to rehabilitate the lost voice of laryngectomied patients has been usedwide in our country. Although the study of biofilm on voice prostheses has beendone many years in foreign, our work is seldom. The amid of this study is toidentify the microbial colonization of dysfunctioning Groningen silicone voiceprostheses and compare the microbial composition with the study of foreign, inorder to provide the theoretical basis of selectiving optimal methods prolongingthe lifetime of the silicone voice prostheses. Considering the dietary habits of ourpatients, we analyze the dietary constitution of the patients and hope to prolongthe lifetime of voice prostheses by adjusting the dietary constitution of thepatients, which can avoid the development of resistant strains leading byantifungal agents or other agents and side effect of drugs, also can relief theeconomical burden.【Methods】This study is to identify the microbial colonization ofdysfunctioning silicone Groningen voice prostheses and compare the microbialcomposition with the study of foreign and we analyze the dietary constitution ofthe different patients. Our trial'datas were dealed with t-test and mean square analysis by SPSS 13.0【Results】The explanted dysfunctioning Groningen voice prostheses showedmacroscopically visible large brown deposits on the esophageal side of theprostheses. The explanted voice prostheses were seen an enormous variety inmacroscopically visible deterioration of the silicone rubber on the valve side. Theculture results showed that most of the bacterial strains identified werestaphylococci (27 isolates), streptococci (45 isolates). They were normalmicroorganisms present on the skin and in the oral cavity. 19 voice prostheseswere colonized by Staphylococcus aureus; Klebsiella pneumoniae was isolatedfrom 6 voice prostheses; Pseudomonas aeruginosa was isolated from 3 voiceprostheses. In our test we only identified three Candida species, Candidaalbicans, Candida tropicalis and Candida glabrata which were generally holdresponsible for deterioration of the silicone voice prostheses. Candida tropicaliswas identified on 27 Groningen voice prostheses; Candida albicans was thecolonizing yeast on 19 Groningen voice prostheses; Candida glabrata was on 14Groningen voice prostheses; 16 voice prostheses were colonized by Candidaalbicans in conjunction with Candida tropicalis; All this three yeasts coexistedon 3 voice prostheses. We also analyzed the coexisting of Staphylococcus aureusand Candida species. A combination of Staphylococcus aureus and Candidaalbicans were seen on 8 voice prostheses; A combination of Staphylococcusaureus and Candida tropicalis on 13 Groningen voice prostheses; Saphylococcusaureus,Candida albicans and Candida tropicalis coexisted on 2 Groningen voiceprostheses. We analyzed the constituent of the foods of patients and found in theextended lifetime group the content of Vc, vegetable, and fruits in the diet ofpatients was higher than the content of the short lifetime group. There wassignificance difference. We also found the patients in the extended lifetime groupt had many kinds of foods and the dietary constitution of the patients is morebalance.【Conclusions】Biofilm formation on the esophageal side of the Groningen silicone voice prostheses was the main cause leading deterioration of the siliconematerial. Some bacterial and yeasts play important role in the deterioration ofthe silicone voice prostheses, so prophylactic measures should eliminate thosemicroorganisims. Identifying the microbial colonization of dysfunctioningGroningen silicone voice prostheses provides the theoretical basis of selectivingoptimal methods prolonging the lifetime of the silicone voice prostheses.According to our patients' special dietary habits, increasing prosthesis lifetimesmay be expected from carefully designed dietary constructions of patients...