Clinical application of the Provox NiD voice prosthesis: a longitudinal study.

OBJECTIVES/HYPOTHESIS To evaluate the indications, complications, and device life of the Provox NiD in a large cohort at a tertiary US cancer center. STUDY DESIGN Longitudinal retrospective cohort study. METHODS We reviewed the records of patients who used the NiD prosthesis (2005-2011) for general indicators, device life, and complications. RESULTS One hundred eighty-six patients who used the NiD were included (median follow-up: 21.4 months). The NiD was placed at initial fit in 41 (22%) patients, whereas 145 (78%) tried an NiD after using another type of prosthesis. Most patients used the NiD similarly to an indwelling device. Median NiD device life was significantly longer than that of other nonindwelling prostheses (45 vs. 29 days, P=.0061), and did not significantly differ from that of standard indwelling devices (45 vs. 50 days, P=.4263). Thirty-eight percent (71 of 189) of NiD users had a history of early leakage (<8 weeks) using a different prosthesis before trying the NiD. Among patients with a pre-existing history of early leakage, almost 90% of NiD prostheses outperformed the device life of other products. CONCLUSIONS The NiD prosthesis offers satisfactory device life on a par with indwelling prostheses in our cohort of NiD users. Coupled with favorable published airflow characteristics and satisfactory tracheoesophageal voice, these data suggest that the NiD offers a durable, low-cost prosthetic alternative in contemporary practice. A unique indication for NiD may be improved device life in some patients with a history of early leakage. LEVEL OF EVIDENCE 4.