Double Blind Study Investigating the Effect of Different Voice Prostheses on Ease of Swallowing and Residue Post Laryngectomy.
Margaret M Coffey, Neil Tolley, David Howard and 1 others
PMID 29460049WHAT IT FOUND
Neither patients nor experts consistently identified one best voice prosthesis for swallowing.
Experts did find less residue with the Blom Singer Classic Indwelling on thin liquids and the Provox Vega on soft foods, but patient ratings showed no difference between devices.
Key findings
01Patient self-evaluations showed no significant difference in swallowing ease between the six voice prostheses tested.
02Expert raters identified significant differences in residue on the prosthesis for thin liquids and soft consistencies, with the Blom Singer Classic Indwelling showing the least residue on thin liquids.
03For upper esophageal residue on soft foods, experts found the Blom Singer Low Pressure had the least residue.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study had poor inter-rater reliability, with experts agreeing on only 3 of 8 rating questions, suggesting the residue judgments were highly subjective. Participants wore the prostheses for only a short period during clinic visits, which does not reflect real-world use over days or weeks. The sample size was small (40 participants), and the study was a pilot, limiting the generalizability of the findings. All participants had previously used Blom Singer prostheses, which may have influenced their tolerance or perception of the new devices.
Declared interests
The study was funded by the Research Trainees Coordinating Centre. The text does not explicitly state whether the manufacturers of the voice prostheses (InHealth Technologies, Atos Medical) were involved in the design, data collection, or analysis, though they are named as the suppliers of the devices.
The easy way to misread this
Do not assume that the prostheses with less residue on FEES will actually improve the patient's subjective swallowing experience. In this study, patients reported no difference between the devices despite the expert-identified variations in residue.